Individual
MRS. WANDA MAE DETTINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC LSW
Contact information
Practice address
1418 A MACCORKLE AVE SW, CHARLESTON, WV 25303
(304) 348-1288
(304) 348-1262
Mailing address
PO BOX 4009, CHARLESTON, WV 25364-4009
(304) 348-1288
(304) 348-1262
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1564
WV
104100000X
Social Worker
Primary
AP00938675
WV
Other
Enumeration date
07/17/2006
Last updated
09/11/2025
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