Individual
MRS. SANDRA JACKSON HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
879 NE MAIN ST STE A, SIMPSONVILLE, SC 29681-2056
(864) 688-9416
(844) 300-6266
Mailing address
1735 SAINT JULIAN PL STE 300, COLUMBIA, SC 29204-2402
(803) 708-5081
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
8841
SC
101YM0800X
Mental Health Counselor
Primary
8841
SC
101YP2500X
Professional Counselor
8841
SC
Other
Enumeration date
05/26/2016
Last updated
08/04/2023
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