Provider Demographics
NPI:1255412581
Name:POSEY, WILDA (MA)
Entity type:Individual
Prefix:
First Name:WILDA
Middle Name:
Last Name:POSEY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RR 6 BOX 219
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-8824
Mailing Address - Country:US
Mailing Address - Phone:304-472-8767
Mailing Address - Fax:
Practice Address - Street 1:RR 1 BOX 208
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:WV
Practice Address - Zip Code:26287-9509
Practice Address - Country:US
Practice Address - Phone:304-478-3339
Practice Address - Fax:304-478-3311
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810006118Medicaid