Healthcare Provider Details

I. General information

NPI: 1356302459
Provider Name (Legal Business Name): MARIE C VEITIA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 20TH ST SUITE 205
HUNTINGTON WV
25703-2071
US

IV. Provider business mailing address

1115 20TH ST SUITE 205
HUNTINGTON WV
25703-2071
US

V. Phone/Fax

Practice location:
  • Phone: 304-691-1500
  • Fax: 304-523-4358
Mailing address:
  • Phone: 304-691-1500
  • Fax: 304-523-4358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number437
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: