Individual
CUCKOO MARIAM THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4500 8TH DIVISION RD, COLUMBIA, SC 29207-5700
(803) 751-2059
Mailing address
315 BLUESTEM DR, ELGIN, SC 29045-2103
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
200029
SC
Other
Enumeration date
01/28/2025
Last updated
01/28/2025
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