Individual
LAURA EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
BPOO943647
WV
1041C0700X
Clinical Social Worker
CP00943647
WV
1041C0700X
Clinical Social Worker
Primary
DP00943647
WV
Other
Enumeration date
11/17/2014
Last updated
06/06/2019
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