Healthcare Provider Details

I. General information

NPI: 1841591435
Provider Name (Legal Business Name): MRS. APRIL DELANE HAROLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2010
Last Update Date: 11/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 GREYSTONE DR
BEAVER WV
25813-9154
US

IV. Provider business mailing address

200 GREYSTONE DR
BEAVER WV
25813-9154
US

V. Phone/Fax

Practice location:
  • Phone: 304-860-1952
  • Fax:
Mailing address:
  • Phone: 304-860-1952
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number9006
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: