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Certified Provider Details:
| PROVIDER NUMBER: | 490098 |
| AGENCY NAME: | WV Coalition Against Domestic Violence |
| CONTACT NAME: | Angie Rosser |
| ADDRESS: | 5004 Elk River Rd. S |
| CITY: | Elkview |
| STATE: | WV |
| ZIP: | 250719619 |
| PHONE: | |
| WEB SITE: | www.wvcadv.org |
| EMAIL ADDRESS: | arosser@wvcadv.org |
| BSW/MSW NAME: | Harriet Sutton, MSW, ACSW |
| DUE TO RECERTIFY DATE: | 7/1/2010 |
| COMMENTS: |