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1306495684
TIFFANY ONESSIA SHABAZZ
GREENWOOD, SC
NPI
1306495684
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2019-09-09
Last Update Date
2019-09-09
Business Address
MRS. TIFFANY ONESSIA SHABAZZ
1612 RIVERS ST
GREENWOOD, SC 29649-8513
Phone number: 864-227-1001
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Mailing Address
MRS. TIFFANY ONESSIA SHABAZZ
PO BOX 50209
GREENWOOD, SC 29649-0021
Phone number: 864-227-1001
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