Individual
TINA EDGELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
166 THOMPSON DR, BRIDGEPORT, WV 26330-1644
(304) 842-6001
(304) 842-6111
Mailing address
166 THOMPSON DRIVE, BRIDGEPORT, WV 26330
(304) 842-6001
(304) 842-6111
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
BP00941086
WV
Other
Enumeration date
07/13/2006
Last updated
07/08/2007
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