Individual
SHASTA THURMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
199 HERLONG AVE S, ROCK HILL, SC 29732-1186
(803) 324-0404
Mailing address
199 HERLONG AVE S, ROCK HILL, SC 29732-1186
(803) 323-3861
(803) 981-6982
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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