Individual
MS. TAMARA A WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4221 MAYFAIR ST, SUITE 207, MYRTLE BEACH, SC 29577-5757
(843) 360-9491
Mailing address
305 MAPLE ST, MYRTLE BEACH, SC 29577-3902
(843) 360-9491
(843) 448-8050
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
4859
SC
Other
Enumeration date
03/16/2008
Last updated
11/10/2009
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