Individual
SONJA CRAWFORD TEASLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 LACY LN, ANDERSON, SC 29621-5063
(864) 556-3934
Mailing address
110 LACY LN, ANDERSON, SC 29621-5063
(864) 556-3934
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
23810
SC
Other
Enumeration date
10/29/2021
Last updated
10/29/2021
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