Individual
MS. MARY KATLYN MINTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DS
Contact information
Practice address
631 GORDON DR, CHARLESTON, WV 25314-1751
(681) 460-4571
Mailing address
631 GORDON DR, CHARLESTON, WV 25314-1751
(681) 460-4571
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
WV
Other
Enumeration date
12/20/2024
Last updated
12/20/2024
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