Organization
MUSTANG MEDICINE WORKS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRELL GENE YARDLEY PH.D., LPC (DIRECTOR)
(864) 508-0781
Entity
Organization
Contact information
Practice address
5642 MOOREFIELD MEMORIAL HWY., LIBERTY, SC 29657
(864) 508-0781
Mailing address
PO BOX 702, LIBERTY, SC 29657-0702
(864) 508-0781
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5933
SC
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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