Organization
AVONDALE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISE RICHARD (OWNER)
(843) 870-0278
Entity
Organization
Contact information
Practice address
845 SAVANNAH HWY, SUITE 1C, CHARLESTON, SC 29407-7202
(843) 870-0278
Mailing address
845 SAVANNAH HWY, SUITE 1C, CHARLESTON, SC 29407-7202
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1528
—
SC
Enumeration date
02/09/2016
Last updated
02/09/2016
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