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Individual

MARCIA M TREJO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
209 HAYWORTH RD, SUMMERVILLE, SC 29486-7104
(803) 243-4003
Mailing address
209 HAYWORTH RD, SUMMERVILLE, SC 29486-7104
(803) 243-4003

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
005213
CT
101YM0800X
Mental Health Counselor
4111
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
435201
SC
Enumeration date
03/05/2020
Last updated
04/07/2022
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