Individual
LELA OWUSU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560
(304) 757-6999
(304) 201-5019
Mailing address
97 GREAT TEAYS BLVD STE 6, SCOTT DEPOT, WV 25560-9816
(304) 757-6999
(304) 201-5019
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
AP00943535
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952801250
—
WV
01
—
Q59532A
MEDICARE PTAN
WV
Enumeration date
02/14/2018
Last updated
10/15/2019
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