Individual
ALFARE FIELDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
65 FORREST DRIVE, VARNVILLE, SC 29944
(803) 943-2828
Mailing address
1050 RIBAUT RD, BEAUFORT, SC 29902-5400
(843) 524-3378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0641
SC
Other
Enumeration date
09/05/2006
Last updated
07/08/2007
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