Organization
JERIDO-FAIR COUNSELING SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
(912) 484-3879
Entity
Organization
Contact information
Practice address
608 KING ST, WALTERBORO, SC 29488-5330
(843) 635-0149
Mailing address
608 KING ST, WALTERBORO, SC 29488-5330
(843) 635-0149
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6284
SC
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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