Individual
SHATIRA EBONY CHAMPION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
2822 CHARLESTON HWY, ORANGEBURG, SC 29115-9210
(386) 631-6052
Mailing address
2822 CHARLESTON HWY, ORANGEBURG, SC 29115-9210
(386) 631-6052
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/16/2012
Last updated
05/27/2022
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