Individual
MATTHEW DOMINIC PASCAVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 LADY ST, COLUMBIA, SC 29201-3402
(803) 766-2188
Mailing address
2113 GREENWYCHE AVE, COLUMBIA, SC 29210-6232
(336) 905-1253
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
9130
SC
Other
Enumeration date
02/04/2025
Last updated
02/07/2025
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