Provider Demographics
NPI:1508638818
Name:HALTERMAN, BOBBI JO
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JO
Last Name:HALTERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BOBBI
Other - Middle Name:JO
Other - Last Name:WITHERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:99 EDMISTON WAY STE 211
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-8916
Mailing Address - Country:US
Mailing Address - Phone:304-613-9577
Mailing Address - Fax:
Practice Address - Street 1:99 EDMISTON WAY STE 211
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-8916
Practice Address - Country:US
Practice Address - Phone:304-613-9577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management