Individual
MRS. JACQUELYN REED GLADDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
1135 CARTER ST, COLUMBIA, SC 29204-2811
(803) 786-1183
Mailing address
402 KOON STORE RD, COLUMBIA, SC 29203-9573
(803) 754-4739
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3032
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3032
SOCIAL WORKER
SC
Enumeration date
11/29/2006
Last updated
07/08/2007
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