Individual
MRS. CATHERINE MARIE MOOREHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDMS, CMC, QRP
Contact information
Practice address
131 DANIELS ST, FAYETTEVILLE, WV 25840-1215
(304) 574-2950
(304) 574-2958
Mailing address
PO BOX 81, FAYETTEVILLE, WV 25840-0081
(304) 574-2950
(304) 574-2958
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
00000260
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000260
QRP
WV
01
—
00044981
CDMS
WV
01
—
281745303-00
PROVIDER NUMBER, OBWC
OH
Enumeration date
06/28/2007
Last updated
07/08/2007
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