Individual
MRS. PANORA ZENIK WALLACE-JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
576 W CAROLINA AVE, HARTSVILLE, SC 29550-5412
(843) 309-9340
(843) 309-9341
Mailing address
576 W CAROLINA AVE, HARTSVILLE, SC 29550-5412
(843) 309-9340
(843) 309-9341
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/08/2007
Last updated
03/12/2014
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