Individual
JENNIFER CORRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 20TH ST, VIENNA, WV 26105-1256
(304) 485-9838
Mailing address
915 20TH ST, VIENNA, WV 26105-1256
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
58004
WV
Other
Enumeration date
02/18/2025
Last updated
02/18/2025
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