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Individual

MS. SUSAN RENNAE KIRKENDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS,AADC

Contact information

Practice address
527 MEDICAL PARK DR, BRIDGEPORT, WV 26330-9008
(304) 933-3884
Mailing address
1100 ANDREW DR, MORGANTOWN, WV 26508-6842
(304) 290-6533

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
98-302
WV

Other

Enumeration date
09/28/2018
Last updated
09/28/2018
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