Individual
CLARICE MCKINNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
328 GLEN ST, SUMMERVILLE, SC 29483-4653
(843) 934-2697
Mailing address
1701 N QUAKER AVE APT 425B, LUBBOCK, TX 79416-2350
(325) 718-8563
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
106S00000X
Behavior Technician
Primary
RBT-25-412847
SC
Other
Enumeration date
05/26/2023
Last updated
03/28/2025
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