Individual
SAMANTHA MOGABGAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2309 DEVINE ST, COLUMBIA, SC 29205-2422
(980) 621-4523
Mailing address
2309 DEVINE ST, COLUMBIA, SC 29205-2422
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
7705
SC
Other
Enumeration date
06/25/2021
Last updated
07/05/2021
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