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1992160980
LONNIE LEWIS WADE
BENNETTSVILLE, SC
NPI
1992160980
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-12-18
Last Update Date
2019-08-08
Business Address
LONNIE LEWIS WADE MA
1035 CHERAW STREET
BENNETTSVILLE, SC 29512
Phone number: 843-454-0841
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Mailing Address
LONNIE LEWIS WADE MA
PO BOX 918
BENNETTSVILLE, SC 29512
Phone number: 843-454-0841
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