Individual
STEPHANIE HENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
828 WAPPOO RD, CHARLESTON, SC 29407-5865
(843) 297-8470
Mailing address
4700 OLD PARK RD, NORTH CHARLESTON, SC 29405-4785
(843) 696-7528
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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