Individual
GENICE HALL-FOWLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
3 JOHNNY LORICK CT, IRMO, SC 29063-8955
(803) 673-8459
Mailing address
3 JOHNNY LORICK CT, IRMO, SC 29063-8955
(803) 673-8459
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
006600
SC
Other
Enumeration date
09/18/2012
Last updated
03/03/2025
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