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General NPI Number Information
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NPI Number | 1598279176
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Entity Type | Organization
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Legal Business Name | NURTURE AND BALANCE PLLC
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Dates
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Enumeration Date | 11/19/2017
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Last Update Date | 11/26/2017
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Provider Practice Location Address
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Address Line | 142 N QUEEN ST STE 105
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City | MARTINSBURG
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State | WV
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Zip | 25401-3312
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Country | US
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Telephone | 304-579-1515
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Fax |
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Provider Business Mailing Address
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Address Line | 142 N QUEEN ST STE 105
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City | MARTINSBURG
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State | WV
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Zip | 25401-3312
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Country | US
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Telephone | 304-240-2698
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Fax |
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MISS BIANCA STEVENS
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Credential | CCMA(NHA)
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Telephone | 304-240-2698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | WV
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