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Individual

MS. OLIVIA LEA SHUTTLEWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
1659 HORNBECK RD, MORGANTOWN, WV 26508-4757
(304) 629-1779
Mailing address
1659 HORNBECK RD, MORGANTOWN, WV 26508-4757
(304) 629-1779

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CW013709
PA
1041C0700X
Clinical Social Worker
Primary
DP00453081
WV

Other

Enumeration date
09/05/2006
Last updated
08/27/2015
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