Individual
THERESA MARIE KOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
155 CHEYENNE TRL, ONA, WV 25545-9754
(304) 395-3464
Mailing address
155 CHEYENNE TRL, ONA, WV 25545-9754
(304) 395-3464
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
11/25/2024
Last updated
11/25/2024
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