Individual
TIFFANY NICOLE HENDERSHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
100 MILITARY DR, SOUTH CHARLESTON, WV 25309-8246
(304) 352-3613
Mailing address
2525 PIGEON COVE RD, WARFORDSBURG, PA 17267-8910
(304) 320-1165
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00944330
WV
Other
Enumeration date
11/05/2018
Last updated
11/05/2018
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