Charla Dawn Blosser
Individual provider Active NPI Early Intervention Provider Agency · Core, WV
NPI 1407694102 · NPPES record last updated Jul 17, 2024
Key facts
- NPI
- 1407694102
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Early Intervention Provider Agency 252Y00000X
- Practice address
- 170 Merle Yost Rd
Core, WV 26541-6918 - Phone
- (304) 278-7069
- NPI assigned
- Jul 17, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Early Intervention Provider Agency | 252Y00000X | Yes |
Addresses
Primary practice location
170 Merle Yost Rd
Core, WV 26541-6918
Mailing address
170 Merle Yost Rd
Core, WV 26541-6918
Phone (304) 278-7069
Other providers in Core, WV
All providers in Core, WV · Early Intervention Provider Agency in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.