Individual
MS. JACQUELYN L. BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
SWCMHC LEE CMHC, 817 BROWN ST., BISHOPVILLE, SC 29010
(803) 484-9414
(803) 484-4299
Mailing address
SWCMHC, 215 N. MAGNOLIA ST., SUMTER, SC 29151-1946
(803) 775-9364
(803) 773-6615
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/23/2006
Last updated
07/08/2007
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