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Certified Provider Details:
| PROVIDER NUMBER: | 490049 |
| AGENCY NAME: | Shepherd University Social Work Dept. |
| CONTACT NAME: | Douglas C. Horner, Ph.D. |
| ADDRESS: | 315 White Hall |
| CITY: | Shepherdstown |
| STATE: | WV |
| ZIP: | 25443 |
| PHONE: | |
| WEB SITE: | www.shepherd@edu/swwcb |
| EMAIL ADDRESS: | dhorner@shepherd.edu |
| BSW/MSW NAME: | Douglas C. Horner Ph.D. |
| DUE TO RECERTIFY DATE: | 7/1/2020 |
| COMMENTS: |