Individual
AMANDA FARMER KISSIAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 E HOME AVE, HARTSVILLE, SC 29550-3712
(843) 917-0495
Mailing address
122 E HOME AVE, HARTSVILLE, SC 29550-3712
(843) 917-0495
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/03/2023
Last updated
10/03/2023
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