Individual
MALLORY ELIZABETH CAMPBELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2105 COMMERCE DR, CAYCE, SC 29033-1524
(803) 796-6179
Mailing address
811 POLO RD APT 521, COLUMBIA, SC 29223-4426
(508) 713-5695
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
09/03/2024
Last updated
09/03/2024
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