Provider Demographics
NPI:1336941772
Name:PLYMALE, STEVIE SUE ANN
Entity type:Individual
Prefix:
First Name:STEVIE
Middle Name:SUE ANN
Last Name:PLYMALE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 HUDGINS ST
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601-3535
Mailing Address - Country:US
Mailing Address - Phone:304-752-7830
Mailing Address - Fax:304-752-7832
Practice Address - Street 1:313 HUDGINS ST
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3535
Practice Address - Country:US
Practice Address - Phone:304-752-7830
Practice Address - Fax:304-752-7832
Is Sole Proprietor?:No
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator