Individual
AMANDA MONGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
47 DODD AVE, PETERSBURG, WV 26847-7506
(304) 851-4430
Mailing address
89 JENKINS RUN RD, MOOREFIELD, WV 26836-9703
(304) 851-4430
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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