Individual
BARBARA JEAN THEODORO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
307 N MAIN ST, NEW MARTINSVILLE, WV 26155-1215
(304) 455-3622
(304) 234-3511
Mailing address
1203 5TH ST, NEW MARTINSVILLE, WV 26155-2117
(304) 771-2089
(304) 234-3511
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00941142
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001719068
BCBS
WV
Enumeration date
12/08/2006
Last updated
05/15/2008
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