Individual
MS. PENNY O PERDUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
845 4TH AVE, STE 301, HUNTINGTON, WV 25701
(304) 523-8911
(304) 523-8912
Mailing address
845 4TH AVE, STE 301, HUNTINGTON, WV 25701
(304) 523-8911
(304) 523-8912
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
41
KY
103T00000X
Psychologist
Primary
439
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001722758
BCBS
WV
05
—
0163579000
—
WV
Enumeration date
06/09/2006
Last updated
10/14/2014
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