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Certified Provider Details:
| PROVIDER NUMBER: | 490044 |
| AGENCY NAME: | Center for Excellence in Disabilities |
| CONTACT NAME: | Diane Williams |
| ADDRESS: | 955 Hartman Run Road |
| CITY: | Morgantown |
| STATE: | WV |
| ZIP: | 26505 |
| PHONE: | (304) 293-4692 ext. 1131 |
| WEB SITE: | |
| EMAIL ADDRESS: | awilliams@hsc.wvu.edu |
| BSW/MSW NAME: | Diane Williams |
| DUE TO RECERTIFY DATE: | 7/1/2010 |
| COMMENTS: |