Individual
MS. LUCRETIA GOLDIZEN EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6 PARK ST, PETERSBURG, WV 26847-1765
(304) 257-1155
Mailing address
6 PARK STREET, PETERSBURG, WV 26847
(304) 257-1155
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
DP00942820
WV
Other
Enumeration date
09/29/2009
Last updated
09/29/2009
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