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General NPI Number Information
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NPI Number | 1437379856
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Entity Type | Individual
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Provider Name | AIMEE MARIE PRIDE M.S., CRC, QRP
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Gender | Female
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 22 GREENTREE VLG
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City | SHINNSTON
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State | WV
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Zip | 26431-9412
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Country | US
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Telephone | 304-377-0381
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Fax | 304-534-3058
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Provider Business Mailing Address
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Address Line | 22 GREENTREE VLG
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City | SHINNSTON
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State | WV
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Zip | 26431-9412
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Country | US
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Telephone | 304-377-0381
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Fax | 304-534-3058
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | QRP00000111
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License Number State | WV
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