Individual
MRS. SHEENA BLAKE GADDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, LISW-CP
Contact information
Practice address
1229 38TH AVE N # 207, MYRTLE BEACH, SC 29577
(910) 321-8817
Mailing address
1229 38TH AVE N # 207, MYRTLE BEACH, SC 29577-1313
(843) 804-8200
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12344
SC
1041C0700X
Clinical Social Worker
C010430
NC
Other
Enumeration date
03/11/2010
Last updated
05/30/2018
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