Organization
ADVANTAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIE ESTEP PH.D, AADC (ADDICTIONS SPECIALIST)
(304) 346-8829
Entity
Organization
Contact information
Practice address
2402 KANAWHA BLVD E, CHARLESTON, WV 25311-2323
(304) 389-5535
(304) 346-8829
Mailing address
606 FORT HILL DR, CHARLESTON, WV 25314-1070
(304) 346-8829
(304) 346-8829
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
03-611
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2245-0179
WV STATE TAX DEPARTMENT BUSINESS REGISTRATION
—
Enumeration date
04/21/2016
Last updated
04/21/2016
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