| Shannon K Waliser Licsw Mpa Llc Dba Mind Body Wellness | |
|
295 High St Ste 3 Morgantown WV 26505-5449 | |
| (304) 363-4265 | |
| (304) 999-4826 |
| Full Name | Shannon K Waliser Licsw Mpa Llc Dba Mind Body Wellness |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 295 High St Ste 3, Morgantown, West Virginia |
| Authorized Official Name and Position | Shannon Kristi Waliser (OWNER) |
| Authorized Official Contact | 3043634265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon K Waliser Licsw Mpa Llc Dba Mind Body Wellness Po Box 1286 Morgantown WV 26507-1286 Ph: (304) 363-4265 | Shannon K Waliser Licsw Mpa Llc Dba Mind Body Wellness 295 High St Ste 3 Morgantown WV 26505-5449 Ph: (304) 363-4265 |
| NPI Number | 1689818379 |
|---|---|
| Provider Enumeration Date | 04/24/2009 |
| Last Update Date | 07/22/2020 |
| Certification Date | 07/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689818379 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | DP00942521 (West Virginia) | Primary |
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