Individual
TIANA JACQUELIN LASPORGARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LGSW
Contact information
Practice address
235 HIGH ST STE 311, MORGANTOWN, WV 26505-5455
(304) 244-0518
Mailing address
235 HIGH ST STE 311, MORGANTOWN, WV 26505-5455
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BP00944639
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689111452
—
WV
Enumeration date
10/15/2019
Last updated
10/15/2019
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