Roark, Renee

Roark, Renee is an sole proprietor health care provider with primary practice located at 110 Mordington Ave , Charles Town WV 25414-1693. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Roark, Renee can be contacted via phone (304) 725-9741.

Contact Information

Primary practice address
110 Mordington Ave Charles Town WV 25414-1693
Phone: (304) 725-9741
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X 6980 West Virginia

Profile Details

NPI number 1093980401
LBN Legal business name Roark, Renee
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 25th, 2008
Last updated Apr 25th, 2008 - 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 1093980401 NPPES
West Virginia MEDICAID 3810004949

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