Individual
SHANNEL EZEDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCI
Contact information
Practice address
1050 RIBAUT RD, BEAUFORT, SC 29902-5400
(857) 540-2095
Mailing address
1050 RIBAUT RD, BEAUFORT, SC 29902-3679
(843) 473-6355
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
03/17/2018
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