Most Relevant Information
Provider Data
| NPI Number: | 1003411596 |
| Provider Name: | CAROLINE BRANNOCK B.A, BCABA |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | 0-20-11462 |
Most Important Dates
| Enumeration Date: | 12/02/2020 |
| Last Updated: | 12/02/2020 |
Provider Practice Location
4614 WAVERLY ROAD
HUNTINGTON
WV
25704
Practice Location Phone/Fax
| Phone: | 3044293287 |
| Fax: | 3044290024 |
Provider Mailing Location
4614 WAVERLY ROAD
HUNTINGTON
WV
25704
Provider Mailing Phone/Fax
| Phone: | 3044293287 |
| Fax: | 3044290024 |