Individual
HAILEE KATHLYNE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 E GRAFTON RD STE C, FAIRMONT, WV 26554-4465
(304) 366-5832
Mailing address
14 E GRAFTON RD STE C, FAIRMONT, WV 26554-4465
(304) 366-5832
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
PL032316567
WV
Other
Enumeration date
01/30/2023
Last updated
05/24/2024
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