Individual
JACLYN MATHISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
23 PLANTATION PARK DR STE 202, BLUFFTON, SC 29910-6072
(843) 290-6828
Mailing address
8 CONSERVANCY CT, HILTON HEAD ISLAND, SC 29926-2637
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6743
SC
Other
Enumeration date
07/14/2018
Last updated
07/14/2018
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