Individual
KIMBERLY DAWN STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
254 W. TURKEY DIP RD., OCEANA, WV 24870
(304) 890-8910
Mailing address
PO BOX 171, OCEANA, WV 24870-0171
(304) 890-8910
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00941456
WV
Other
Enumeration date
05/10/2024
Last updated
12/24/2024
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