Intercessory Counseling and Consulting Outreach INC
NPI #1508473141 in S Charleston, West Virginia
Provider Information
- NPI Number
- 1508473141
- Entity Type
- Organization
- Organization Name
- Intercessory Counseling and Consulting Outreach INC
- Primary Specialty
- Counselor - Professional
- Enumeration Date
- Sep 28, 2020
- Last Updated
- Sep 28, 2020
Practice Location
- Address
- 1113B JEFFERSON RD
- City
- S Charleston
- State
- West Virginia
- ZIP Code
- 25309-9780
- Phone
- (304) 415-5715
Authorized Official
- Name
- DERRICK GIBSON
- Title
- PROVIDER
- Phone
- (304) 415-5715
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Professional — Professional |
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