Individual
STACEY KHALIFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
160 MEDICAL CIR FL 1, WEST COLUMBIA, SC 29169
(803) 796-6811
(803) 796-6851
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
(803) 695-8078
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8744
SC
Other
Enumeration date
01/28/2016
Last updated
08/08/2018
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