Individual
REBECCA E. BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
511 MORRIS ST, CHARLESTON, WV 25301-1326
(304) 341-0511
(304) 341-0499
Mailing address
2157 GREENBRIER ST, CHARLESTON, WV 25311-9623
(304) 344-5924
(304) 356-3239
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CP00942740
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005355002
—
WV
Enumeration date
05/05/2014
Last updated
10/01/2020
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