Individual
LETTY COAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
748 MCMECHEN ST, BENWOOD, WV 26031-1100
(304) 233-3744
Mailing address
748 MCMECHEN ST, BENWOOD, WV 26031-1100
(304) 233-3744
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00000
—
WV
Enumeration date
11/24/2020
Last updated
11/24/2020
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