Organization
LYNETTE CONSULTANTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
(912) 484-3879
Entity
Organization
Contact information
Practice address
2 RIVER CLUB CT, OKATIE, SC 29909-4219
(843) 987-2300
(843) 987-3819
Mailing address
2 RIVER CLUB CT, OKATIE, SC 29909-4219
(843) 987-2300
(843) 987-3819
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
5782
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5782
STATE LICENSE
SC
Enumeration date
06/11/2015
Last updated
06/11/2015
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