Individual
KATIE SOUDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
46 TRIFECTA PL STE 105, CHARLES TOWN, WV 25414-5652
(304) 725-4536
Mailing address
208 E 11TH AVE, RANSON, WV 25438-1508
(484) 896-8238
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
PA
Other
Enumeration date
06/07/2018
Last updated
06/07/2018
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