Individual
KAITLYN MCKENZIE WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA CM
Contact information
Practice address
1289 ROBERT C BYRD DR., SUITE 4, BECKLEY, WV 25802
(304) 228-0889
Mailing address
P.O. BOX 108, DANIELS, WV 25832
(304) 228-0889
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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