Most Relevant Information
Provider Data
| NPI Number: | 1003682733 |
| Provider Name: | KATLYN DOLLY BSW |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/04/2023 |
| Last Updated: | 05/28/2024 |
Provider Practice Location
14 E GRAFTON RD STE C
FAIRMONT
WV
265544465
Practice Location Phone/Fax
| Phone: | 3043665832 |
| Fax: |
Provider Mailing Location
14 E GRAFTON RD STE C
FAIRMONT
WV
265544465
Provider Mailing Phone/Fax
| Phone: | 3043665832 |
| Fax: |