Individual
CLARISSA CARELOCK-LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1147 EBENEZER RD, ROCK HILL, SC 29732-2355
(803) 329-6648
Mailing address
1147 EBENEZER RD, ROCK HILL, SC 29732-2355
(803) 329-6648
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
20069
SC
363LG0600X
Gerontology Nurse Practitioner
Primary
20069
SC
Other
Enumeration date
06/28/2016
Last updated
09/23/2016
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