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Marcella Hairston

Homemaker in Beckley, WV. Individual provider (NPI-1).

NPI number1043922073
StatusActive
Last updated in NPPESMay 11, 2023

Details

NPI
1043922073
Entity type
Individual (NPI-1)
Name
Marcella Hairston
Sex
Female
Sole proprietor
No
Enumeration date
Dec 21, 2022
Certification date
May 11, 2023
Last updated
May 11, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376J00000X Homemaker––Yes

Practice location

108 Saunders Ave
Beckley, WV 25801-6239

Phone 304-255-1397

Mailing address

1614 S Kanawha St
Beckley, WV 25801-6239

Phone 304-255-1397

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