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Individual

TINA SMITH TIMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
418 DORN ST, SUMTER, SC 29150-3822
(843) 401-9494
Mailing address
418 DORN ST, SUMTER, SC 29150-3822
(843) 401-9494

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
SC
Enumeration date
12/09/2022
Last updated
12/09/2022
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