Individual
RICHARD HOWARD SOUTHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 623-5661
Mailing address
6 HOSPITAL PLZ, CLARKSBURG, WV 26301-9316
(304) 622-3721
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1796
WV
Other
Enumeration date
08/20/2006
Last updated
07/08/2007
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