Doctor Name: | JATUE RICHARDSON |
NPI Number: | 1003036823 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BA |
License Number: | |
Business Practice Address: | 2157 Greenbrier St Charleston, WV - 253119623 |
Business Phone Number: | 3043445924 |
Business Fax Number: | 3043443503 |
Mailing Address: | 841 Valley Dr, DUNBAR |
State: | WV |
Postal Code: | 250641131 |
Phone Number: | 3043445924 |
Fax Number: | |
NPI Enumeration Date: | 04/26/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |