Individual
LAURA HETRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
214 FOX HUNT PL, GALIVANTS FERRY, SC 29544-8072
(843) 798-3555
Mailing address
310 AZALEA AVE, MARION, SC 29571-8042
(843) 798-3555
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
16854
SC
104100000X
Social Worker
I.2405539
OH
1041C0700X
Clinical Social Worker
16854
SC
Other
Enumeration date
11/20/2013
Last updated
10/21/2024
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