Individual
TRACI LATRELLE THOMPSON-BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 SPRINGHALL DR STE D, GOOSE CREEK, SC 29445-5335
(843) 789-4464
(843) 970-2411
Mailing address
PO BOX 184, LADSON, SC 29456-1600
(843) 789-4464
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093173874
GOLDEN CARE SOLUTIONS LLC
—
Enumeration date
06/01/2020
Last updated
06/01/2020
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