Individual
MR. KEVIN TALERICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
706 OAK MOUND RD, CLARKSBURG, WV 26301
(304) 969-5072
Mailing address
1107 EAST MAIN STREET, CLARKSBURG, WV 26301
(774) 615-2060
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/28/2024
Last updated
08/28/2024
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