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Individual

KATHERINE D. LARUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
195 GOLDEN BEAR DR, NEW CUMBERLAND, WV 26047-1672
(304) 564-3411
(304) 564-3990
Mailing address
PO BOX 1300, NEW CUMBERLAND, WV 26047-1300
(304) 564-3411
(304) 564-3990

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
298
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0159198000
WV
Enumeration date
01/16/2008
Last updated
01/16/2008
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