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Individual

AMANDA JEAN HALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
504 WALNUT ST, GRAFTON, WV 26354-1751
(304) 918-7002
Mailing address
504 WALNUT ST, GRAFTON, WV 26354-1751

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
WV

Other

Enumeration date
12/18/2020
Last updated
12/18/2020
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