Individual
MRS. RENDA KAY FAULKENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W., L.I.S.W.
Contact information
Practice address
2025 EBENEZER RD, SUITE J-2, ROCK HILL, SC 29732-1062
(803) 366-2525
(803) 366-2527
Mailing address
2025 EBENEZER RD., SUITE J-2, ROCK HILL, SC 29732
(803) 366-2525
(803) 366-2527
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6922
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00192033
RAILROAD MEDICARE
SC
Enumeration date
11/13/2006
Last updated
12/10/2007
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