Individual
TEISHA MARIE PRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PRSS
Contact information
Practice address
206 SPRUCE ST, MORGANTOWN, WV 26505-7539
(304) 413-4300
Mailing address
206 SPRUCE ST, MORGANTOWN, WV 26505-7539
(304) 413-4300
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
21-9105
WV
Other
Enumeration date
08/15/2022
Last updated
08/15/2022
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