Individual
DIAMOND CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
30 POINTE CIR, GREENVILLE, SC 29615-3506
(864) 561-8953
Mailing address
299 FENWICK DR, WOODRUFF, SC 29388-8046
(803) 767-0350
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10174
SC
Other
Enumeration date
09/05/2024
Last updated
09/05/2024
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