Individual
KIMBERLY HUNTER SHIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 CLAUDE BUNDRICK RD, KIVA LODGE, BLYTHEWOOD, SC 29016-9420
(803) 754-5478
(803) 754-9644
Mailing address
204 GREEN ROSE RD, COLUMBIA, SC 29229-9137
(803) 446-7226
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
SC
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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