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Individual

KATHERINE ROSE LAISHLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LGSW

Contact information

Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2545
(304) 388-2781
Mailing address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2545
(304) 388-2781

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BP00945726
WV
101YM0800X
Mental Health Counselor
BP00945726
WV

Other

Enumeration date
09/01/2020
Last updated
09/01/2020
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