Individual
ZACK JOHN HUMBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LGSW
Contact information
Practice address
701 BENONI AVE, FAIRMONT, WV 26554-2508
(304) 746-2918
Mailing address
701 BENONI AVE, FAIRMONT, WV 26554-2508
(304) 746-2918
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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