Individual
LISA CALDWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LSW
Contact information
Practice address
175 PHILPOT LANE, BEAVER, WV 25813
(304) 254-9262
Mailing address
PO BOX 573, ATHENS, WV 24712-0573
(304) 887-6181
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00938538
WV
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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