Individual
CORDELIA ELIZABETH DALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBA
Contact information
Practice address
2049 SAVANNAH HWY STE D, CHARLESTON, SC 29407-2228
(315) 992-1929
Mailing address
122 HARVEY AVE, GOOSE CREEK, SC 29445-4208
(913) 313-5407
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
004676-01
NY
103K00000X
Behavior Analyst
1-25-86171
—
Other
Enumeration date
11/18/2024
Last updated
08/03/2026
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