Individual
KATHI A PEDDICORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
75 SPRINGVIEW LN, SUMMERVILLE, SC 29485-8154
(843) 813-9650
Mailing address
116 OAKBLUFF RD, SUMMERVILLE, SC 29485-8449
(843) 813-9650
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7394
SC
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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