Provider Information for 1154999704
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TASHEENA RENEE DONELL LPC
Sex: Female
NPI: 1154999704
Last Updated: 2023-11-05
Certification Date: 2023-11-05
Certification Date: 2023-11-05
Details
| Name | Value | ||||||||
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| NPI | 1154999704 | ||||||||
| Enumeration Date | 2021-06-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 111 ALBERT AVE BECKLEY, WV 25801-2001 United States Phone: 304-651-7992 | Fax: | ||||||||
| Primary Practice Address | 111 ALBERT AVE BECKLEY, WV 25801-2001 United States Phone: 304-651-7992 | Fax: | ||||||||
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