Individual
JAH'RENA EBONAE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA, ABO, LDO
Contact information
Practice address
10060 TWO NOTCH RD, COLUMBIA, SC 29223-4396
(803) 419-6240
(803) 419-6742
Mailing address
10060 TWO NOTCH RD, COLUMBIA, SC 29223-4396
(803) 419-6240
(803) 419-6742
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1460
SC
Other
Enumeration date
01/01/2025
Last updated
01/07/2025
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