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Individual

ETHENA K PRICE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
3375 US ROUTE 60, HUNTINGTON, WV 25705-2837
(304) 525-7851
(304) 525-1073
Mailing address
5600 US ROUTE 60, HUNTINGTON, WV 25705-2146
(304) 525-7851
(304) 525-1073

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CP00944157
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0005355002
WV
Enumeration date
01/17/2014
Last updated
01/17/2014
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