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1134405442
CONSTANCE J BANTA
MORGANTOWN, WV
NPI
1134405442
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: WV 2018)
Enumeration Date
2011-11-01
Last Update Date
2011-11-01
Business Address
-- CONSTANCE J BANTA LPC
930 CHESTNUT RIDGE RD
MORGANTOWN, WV 26505-2807
Phone number: 304-598-4214
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Mailing Address
-- CONSTANCE J BANTA LPC
PO BOX 780
MORGANTOWN, WV 26507-0780
Phone number: 304-293-7401
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