Individual
SOCORRO WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 726-9300
(803) 726-9485
Mailing address
2711 COLONIAL DR, COLUMBIA, SC 29203-6818
(803) 726-9300
(803) 726-9485
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
570510076
SC
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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