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NPI Code Detail

MEDICARE: HOLLY RADFORD

MEDICARE:   HOLLY  RADFORD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1417617127
Entity Type Code : Individual
Provider Name (Legal Business Name) : HOLLY RADFORD
Provider Business Mailing Address
First Line : 1303 WASHINGTON ST W
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-1333
Country : US
Telephone Number : 304-202-1699
Fax Number :
Provider Business Practice Location Address
First Line : 1303 WASHINGTON ST W
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-1333
Country : US
Telephone Number : 304-202-1699
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2021
Last Update Date : 12/21/2021

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Directions to “ HOLLY RADFORD ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.