Pack, Lothell

Pack, Lothell is an sole proprietor health care provider with primary practice located at 66 School St , Logan WV 25601-9605. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Pack, Lothell can be contacted via phone (304) 792-2087.

Contact Information

Primary practice address
66 School St Logan WV 25601-9605
Phone: (304) 792-2087
Fax: (304) 752-7471
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 103TS0200X 21037 West Virginia

Profile Details

NPI number 1750469185
LBN Legal business name Pack, Lothell
Credentials M.A., ED.S.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 2nd, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750469185 NPPES
West Virginia MEDICAID 0166298000

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