Individual
JENNIFER PULICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 PROFESSIONAL PL, BRIDGEPORT, WV 26330-4599
(304) 460-5123
Mailing address
1203 PEACOCK LN, FAIRMONT, WV 26554-2417
(304) 657-4336
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
753
WV
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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