Individual
JACQUELYNN MARIE AMICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
101 EXECUTIVE CENTER DR, STE. 120, COLUMBIA, SC 29210-8411
(843) 855-0597
(803) 896-8279
Mailing address
101 EXECUTIVE CENTER DR, STE. 120, COLUMBIA, SC 29210-8411
(843) 855-0597
(803) 896-8279
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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