Individual
JOANN EZRA GAVALDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, CAC
Contact information
Practice address
226 MCGEE RD, ANDERSON, SC 29625-2104
(864) 260-4169
Mailing address
226 MCGEE RD, ANDERSON, SC 29625-2104
(864) 260-4169
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
6481
SC
Other
Enumeration date
02/18/2013
Last updated
01/23/2018
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