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Organization
BRIDGES CLUBHOUSE MENTAL HEALTH OF AMERICA SOUTH CAROLINA
Active
Organization
BRIDGES CLUBHOUSE MENTAL HEALTH OF AMERICA SOUTH CAROLINA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KELLY ANN TUCKER M.R.C. (CLINICAL COUNSELOR)
(803) 796-0353
Entity
Organization
Contact information
Practice address
2105 COMMERCE DR, CAYCE, SC 29033-1524
(803) 796-6179
Mailing address
2021 ELM ABODE TER, COLUMBIA, SC 29210-7724
(803) 446-4246
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
01858 600
SC
Other
Enumeration date
05/30/2007
Last updated
08/07/2007
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