Individual
KATHLENA MAE MINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 HARLEY LANE, ROMNEY, WV 26757
(304) 813-7784
Mailing address
111 HARLEY LANE, ROMNEY, WV 26757-7033
(304) 359-1417
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
10/16/2020
Last updated
03/21/2025
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