Individual
CHARLOTTE MOODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 PAW PAW STREET 303, GRANT TOWN, WV 26574
(304) 842-0200
Mailing address
120 PAW PAW STREET BOX 303, GRANT TOWN, WV 26574
(304) 842-0200
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
03/17/2023
Last updated
03/17/2023
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