Individual
MARTA CAROLYN ROTELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
507C 31ST AVE. N., MYRTLE BEACH, SC 29577-2905
(843) 251-4208
(843) 626-0189
Mailing address
PO BOX 2554, MYRTLE BEACH, SC 29578-2554
(843) 251-4208
(843) 626-0189
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
2272
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP9919
—
SC
Enumeration date
08/28/2009
Last updated
11/08/2011
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