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1104578061
JACQUANNA JANICE LEYSATH
WEST COLUMBIA, SC
NPI
1104578061
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251S00000X Community/Behavioral Health
Enumeration Date
2022-01-21
Last Update Date
2022-01-21
Business Address
JACQUANNA JANICE LEYSATH
1607 F AVE
WEST COLUMBIA, SC 29169-6174
Phone number: 803-552-1102
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Mailing Address
JACQUANNA JANICE LEYSATH
1607 F AVE
WEST COLUMBIA, SC 29169-6174
Phone number: 803-552-1102
Copy
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