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General NPI Number Information
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NPI Number | 1174231997
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Entity Type | Individual
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Provider Name | EMILY CAVENDER
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Gender | Female
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 483 COURT ST
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City | ELIZABETH
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State | WV
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Zip | 26143-1109
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Country | US
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Telephone | 304-275-3301
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Fax | 304-275-4798
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Provider Business Mailing Address
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Address Line | PO BOX 609
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City | ELIZABETH
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State | WV
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Zip | 26143-0609
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Country | US
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Telephone | 304-275-3301
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Fax | 304-275-4798
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | PL052115921
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License Number State | WV
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