Individual
PHILLIP EDWARD MAYBERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSAC
Contact information
Practice address
1258 HOLLAND RD, SUFFOLK, VA 23434-6313
(757) 439-2698
Mailing address
55 BEATTIE PL STE 810, GREENVILLE, SC 29601-2191
(864) 527-3145
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
05/30/2019
Last updated
05/30/2019
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