Individual
MARYANN PANCAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
1 MED CENTER DRIVE, CLARKSBURG, WV 26301
(304) 623-3461
(304) 626-7726
Mailing address
RT 5 BOX 20D, BRIDGEPORT, WV 23633
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00940276
WV
Other
Enumeration date
09/26/2006
Last updated
07/08/2007
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