Individual
MISS BODEQUIA SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
108 PALMETTO PARK BLVD STE D, LEXINGTON, SC 29072-7969
(803) 996-1500
Mailing address
500 HARBISON BLVD APT 1315, COLUMBIA, SC 29212-1726
(803) 447-2401
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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