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1235769977
STACIA BENTON
COLUMBIA, SC
NPI
1235769977
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor Mental Health
Enumeration Date
2020-01-22
Last Update Date
2020-01-22
Business Address
STACIA BENTON
2715 COLONIAL DR STE 200A
COLUMBIA, SC 29203-6818
Phone number: 803-898-0934
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Mailing Address
STACIA BENTON
7762 WALNUT ST
SHAW AFB, SC 29152-1516
Phone number:
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