Individual
CRESCENT SHUBRADA JETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 COMMONS BLVD, PIEDMONT, SC 29673-7766
(864) 520-8152
Mailing address
304 TULIP TREE LN, SIMPSONVILLE, SC 29680-7352
(864) 787-9180
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
17691
SC
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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