Individual
MR. DWAYNE ST. THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED
Contact information
Practice address
2100 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5832
(843) 852-4100
Mailing address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230
(310) 390-6612
(310) 398-5690
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760596480
—
SC
Enumeration date
04/09/2009
Last updated
08/05/2021
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