Healthcare Provider Details

I. General information

NPI: 1720915440
Provider Name (Legal Business Name): JAIME TOOLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 CLINES COUNTRY RD
LASHMEET WV
24733-9701
US

IV. Provider business mailing address

292 CLINES COUNTRY RD
LASHMEET WV
24733-9701
US

V. Phone/Fax

Practice location:
  • Phone: 304-809-2337
  • Fax:
Mailing address:
  • Phone: 304-809-2337
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: