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Individual

MRS. SUSAN M BULSZA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
2513 N. OAK ST., SUITE 208, MYRTLE BEACH, SC 29577
(843) 333-6767
(843) 448-9875
Mailing address
PO BOX 50046, MYRTLE BEACH, SC 29579
(843) 333-6767
(843) 448-9875

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4956
SC
101YP2500X
Professional Counselor
4956
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC1089
SC
Enumeration date
10/18/2006
Last updated
04/15/2019
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