Individual
TERA Y ROYSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CM/BA
Contact information
Practice address
570 OFFUTT SCHOOL RD, AUGUSTA, WV 26704-7278
(540) 336-2026
Mailing address
570 OFFUTT SCHOOL RD, AUGUSTA, WV 26704-7278
(540) 336-2026
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
05/25/2021
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