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General NPI Number Information
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NPI Number | 1104239821
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Entity Type | Individual
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Provider Name | KENNETH D OXLEY PSYD
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Gender | Male
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Dates
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Enumeration Date | 06/10/2014
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 3729 TEAYS VALLEY RD STE 100
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City | HURRICANE
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State | WV
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Zip | 25526-9705
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Country | US
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Telephone | 304-760-6040
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Fax | 304-760-6042
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Provider Business Mailing Address
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Address Line | PO BOX 1680
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City | HUNTINGTON
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State | WV
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Zip | 25717-1680
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Country | US
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Telephone | 304-697-1396
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Fax | 304-697-2086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 1105
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License Number State | WV
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