Female

Ravenlou Wamsley

Peer Specialist in Logan, WV(View on Map)

Full Name

Ravenlou Wamsley

NPI Number

1134845373

NPI Type

Individual Provider

Gender

Female

Enumeration Date

10/19/2022

Specialties

(Taxonomies)

Code

175T00000X

Primary Taxonomy

Yes

Licenses

State

West Virginia

License Number

22-9154

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 176
174 LMAH CENTER RD

City

Logan
Logan

State

WV
WV

Postal Code

25601-0176
25601-4058

Country

US
US

Telephone Number

(304) 792-7130
(304) 792-7130

Identifiers

Identifier

22-9154

Identifier State

WV

Identifier Issuer

WV CERTIFICATION BOARD FOR ADDICTION AND PREVENTION PROFESSIONALS

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 10/19/2022

Provider Address

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