Individual
MRS. MELANIE PEEBLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAC 1
Contact information
Practice address
1068 S LAKE DR, LEXINGTON, SC 29073-3720
(803) 726-9417
Mailing address
1068 SOUTH LAKE DR., LEXINGTON, SC 29072
(803) 726-9417
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1112125
CAC
SC
Enumeration date
11/21/2013
Last updated
11/21/2013
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