Individual
JACQUELINE CAVANAGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22347 NORTHWESTERN PIKE, ROMNEY, WV 26757-6343
(304) 822-6616
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
102
WV
Other
Enumeration date
12/30/2020
Last updated
09/11/2023
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