Individual
MRS. LAURA CAMILLE YOKUM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
24 N MAIN ST, PETERSBURG, WV 26847-1518
(304) 257-1044
(304) 257-2681
Mailing address
HC 59 BOX 4, SENECA ROCKS, WV 26884-9526
(304) 567-2488
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
30
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R580231
NATIONAL ADA REGISTRATION
WV
01
—
WV LICENSE NO . 30
STATE LICENSE
WV
Enumeration date
08/03/2005
Last updated
07/08/2007
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