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Individual

PAMELA KRISTIN STAFFORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A.

Contact information

Practice address
6334 SAINT ANDREWS RD, SUITE 204, COLUMBIA, SC 29212-3143
(505) 235-3453
Mailing address
6334 SAINT ANDREWS RD, SUITE 204, COLUMBIA, SC 29212-3143
(505) 235-3453

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
T-0134811
NM
101YP2500X
Professional Counselor
5564
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC1305
SC
Enumeration date
10/18/2010
Last updated
11/18/2013
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