Individual
THERESA A. WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
908 SCARBRO RD, SCARBRO, WV 25917-8837
(304) 469-2905
(304) 465-5486
Mailing address
908 SCARBRO RD, P, SCARBRO, WV 25917-8837
(304) 574-2905
(304) 465-5486
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00942748
WV
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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