Individual
MISS MARTHA K STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.,LPC
Contact information
Practice address
2007 POWERS LN, EFFINGHAM, SC 29541-3161
(843) 319-5198
Mailing address
2007 POWERS LN, EFFINGHAM, SC 29541-3161
(843) 319-5198
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5294
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1277
—
SC
Enumeration date
09/03/2010
Last updated
09/03/2013
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