Individual
EDWARD DELA FUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCDC-I
Contact information
Practice address
COASTAL EMPIRE MENTAL HEALTH CENTER, 1050 RIBAUT ROAD, BEAUFORT, SC 29902
(843) 524-8899
(843) 524-8179
Mailing address
2414 BULL ST, COLUMBIA, SC 29201-1906
(803) 898-2461
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/18/2018
Last updated
07/18/2018
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