Organization
ETERNITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JANE B. RIFFE ED.D. (VICEPRESIDENT, SECRETARY)
(304) 291-5964
Entity
Organization
Contact information
Practice address
112 EUCLID AVE, MORGANTOWN, WV 26501-6584
(304) 291-5964
Mailing address
112 EUCLID AVE, MORGANTOWN, WV 26501-6584
(304) 291-5964
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
529
WV
1041C0700X
Clinical Social Worker
Primary
DP00454299
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SW09442
PTAN
—
Enumeration date
12/30/2006
Last updated
10/29/2011
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