Individual
SHAUNA BRIAWN PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.R.C
Contact information
Practice address
2715 COLONIAL DR, SUITE 200A, COLUMBIA, SC 29203-6818
(803) 898-1555
Mailing address
2715 COLONIAL DR, SUITE 200A, COLUMBIA, SC 29203-6818
(803) 898-1555
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
322842
—
SC
Enumeration date
10/26/2009
Last updated
03/15/2012
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