Mark Vincent Sundstrom, M.S.,LICSW
NPI #1548473903 in Fayetteville, West Virginia
Provider Information
- NPI Number
- 1548473903
- Entity Type
- Individual
- Name
- Mark Vincent Sundstrom, M.S.,LICSW
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Social Worker - Clinical
- Credential
- M.S.,LICSW
- Enumeration Date
- May 8, 2007
- Last Updated
- Jul 9, 2007
Practice Location
- Address
- 209 W MAPLE AVE
- City
- Fayetteville
- State
- West Virginia
- ZIP Code
- 25840-1413
- Phone
- (304) 574-2100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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