Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | 15835 |
NPI | 1023506896 |
---|---|
Provider Name | Dr. Shauna Hyde |
First Address | Parkersburg, WV 26101-8329 |
Second Address | Parkersburg, WV 26101-3427 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2018 |
Last Update Date | 27/04/2018 |