Individual
JOHN PENNINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
223 PRATT AVE, PRATT, WV 25162-0039
(304) 610-6312
Mailing address
PO BOX 39, PRATT, WV 25162-0039
(304) 610-6312
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
2488
WV
Other
Enumeration date
06/17/2020
Last updated
06/17/2020
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