Individual
TABATHA DANIELLE BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
63 CENTRAL AVE, SAINT ALBANS, WV 25177-2411
(304) 638-8766
Mailing address
63 CENTRAL AVE, SAINT ALBANS, WV 25177-2411
(304) 638-8766
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
WV
Other
Enumeration date
10/05/2023
Last updated
04/08/2026
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