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CONWAY, SC
NPI1598250409
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2018-06-25
Last Update Date2018-06-25
Business Address
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2404 WISE RD
CONWAY, SC 29526-5521
Phone number: 843-365-8884
Mailing Address
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PO BOX 136
CONWAY, SC 29528-0136
Phone number: 843-365-8884