Individual
DR. ELISE ANN DRAKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-9969
Mailing address
501 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 388-9969
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1045
WV
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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