Individual
BLAKE SANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1 CARRIAGE LN, BUILDING B, SUITE 102, CHARLESTON, SC 29407
(843) 619-7928
Mailing address
40 CAPTIVA ROW UNIT B, CHARLESTON, SC 29407-9650
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
8502
SC
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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