Individual
MADISON JANEMARIE BAGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
890 JOHNNIE DODDS BLVD, BUILDING 3, SUITE A, MOUNT PLEASANT, SC 29464
(843) 884-3888
Mailing address
111 3RD AVE, MOUNT PLEASANT, SC 29464-2702
(703) 727-3139
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8680
SC
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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