Individual
MARY TOLULOPE ATANDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4615 MACCORKLE AVE SE, CHARLESTON, WV 25304-1849
(304) 356-7035
Mailing address
4615 MACCORKLE AVE SE, CHARLESTON, WV 25304-1849
(304) 356-7035
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
104118
WV
Other
Enumeration date
05/04/2026
Last updated
05/04/2026
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