Individual
TRACEY WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1615 AUGUSTA RD, WEST COLUMBIA, SC 29169-5629
(803) 791-1511
Mailing address
1615 AUGUSTA RD, WEST COLUMBIA, SC 29204
(803) 767-0139
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6827
SC
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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