Individual
MARA ALEXIS KIRKPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
65 PROFESSIONAL PL STE 102, BRIDGEPORT, WV 26330-0259
(304) 848-5770
Mailing address
65 PROFESSIONAL PL STE 102, BRIDGEPORT, WV 26330-0259
(304) 848-5770
(304) 848-0890
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW042015462
WV
Other
Enumeration date
05/18/2020
Last updated
12/14/2022
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