Individual
BRANDY LOUISE SHOEMAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
166 SANDY LN, FORT ASHBY, WV 26719-7124
(304) 788-5467
(304) 788-6363
Mailing address
166 SANDY LN, FORT ASHBY, WV 26719-7124
(301) 268-1944
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
N8A130500136
WV
Other
Enumeration date
01/21/2022
Last updated
12/27/2024
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