Individual
STEPHANIE THRESSA LILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1289 ROBERT C BYRD DR.,, SUITE 4, CRAB ORCHARD, WV 25827-2580
(304) 253-8979
Mailing address
138 COOL LN, SHADY SPRING, WV 25918-8704
(304) 763-7026
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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