Individual
KESHIA MILLEDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 FORUM DR STE 4, COLUMBIA, SC 29229-7980
(803) 542-5573
Mailing address
459 LEE AVE S, FAIRFAX, SC 29827-5414
(803) 542-5573
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9022
SC
Other
Enumeration date
07/25/2023
Last updated
07/25/2023
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