Individual
MRS. MALGORZATA EWA RADZISZEWSKA-PETROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCAC II, AADC, CADC
Contact information
Practice address
897 TYNE DR, FORT MILL, SC 29715-5010
(864) 430-2415
Mailing address
897 TYNE DR, FORT MILL, SC 29715-5010
(864) 430-2415
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
04/03/2023
Last updated
04/03/2023
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