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Individual

KAYLA KNICELEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PLSW

Contact information

Practice address
909 MORGANTOWN AVE, FAIRMONT, WV 26554-4335
(304) 816-1432
Mailing address
909 MORGANTOWN AVE, FAIRMONT, WV 26554-4335
(304) 816-1432

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
PL092015669
WV
171M00000X
Case Manager/Care Coordinator
Primary
PL092015669
WV

Other

Enumeration date
10/03/2022
Last updated
11/22/2022
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