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General NPI Number Information
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NPI Number | 1609222348
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Entity Type | Individual
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Provider Name | TERESA STIRE
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Gender | Female
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Dates
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Enumeration Date | 05/12/2016
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 1224 PINEVIEW DR STE B
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City | MORGANTOWN
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State | WV
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Zip | 26505-0708
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Country | US
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Telephone | 304-692-1131
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Fax |
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Provider Business Mailing Address
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Address Line | 49 PARK RIDGE DR
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City | MORGANTOWN
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State | WV
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Zip | 26508-4032
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Country | US
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Telephone | 304-692-1131
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Fax |
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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 | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 1138
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License Number State | WV
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