Individual
MRS. MADISON VANDERLUGT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14 N CHURCH ST, MANNING, SC 29102-3502
(803) 435-2121
Mailing address
2805 HICKS RD, TURBEVILLE, SC 29162-9106
(843) 598-5397
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YP2500X
Professional Counselor
Primary
8803
SC
Other
Enumeration date
06/14/2023
Last updated
03/26/2024
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