Individual
BILL SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
552 CHERRY CREEK CIR, SHADY SPRING, WV 25918-8723
(304) 763-7088
Mailing address
552 CHERRY CREEK CIR, SHADY SPRING, WV 25918-8723
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1045
WV
Other
Enumeration date
02/08/2013
Last updated
02/08/2013
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