Individual
TERESA LYNN BRANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WVCPRSS, DIRECTOR
Contact information
Practice address
1206 QUARRIER ST, CHARLESTON, WV 25301-1843
(681) 710-3578
Mailing address
1045 6TH ST, CHARLESTON, WV 25302-1413
(681) 319-6631
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
22-992
WV
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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