Basic Information
| Provider Information | |||||||||
| NPI: | 1649625682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PFEIFER | ||||||||
| FirstName: | DOUGLAS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 236 N HILLS DR | ||||||||
| Address2: | |||||||||
| City: | PARKERSBURG | ||||||||
| State: | WV | ||||||||
| PostalCode: | 261049224 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3044818993 | ||||||||
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| Practice Location | |||||||||
| Address1: | 207D COLEGATE DR | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 457502363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7403760930 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/27/2016 | ||||||||
| LastUpdateDate: | 04/27/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | E0008218 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.