Individual
MRS. NICOLETTE D BURNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW
Contact information
Practice address
2117 GERVAIS ST, COLUMBIA, SC 29204
(803) 744-0540
Mailing address
PO BOX 8532, COLUMBIA, SC 29202
(803) 238-6856
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
17221
SC
Other
Enumeration date
06/26/2023
Last updated
10/22/2024
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