Individual provider · Type 1 NPI

Shane Modesitt

Addiction (Substance Use Disorder) Counselor · Parkersburg, WV

NPI number 1104660620 Active

Practice location

425 Juliana St # Na
Parkersburg, WV 26101-5352

Call (304) 893-9777 Map

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1104660620

Shane Modesitt's National Provider Identifier is 1104660620, issued on Jun 20, 2024. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Parkersburg, WV. The record was last updated on Jun 20, 2024.