Individual
QUANETTA JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 SPRINGTREE DR, COLUMBIA, SC 29223-8614
(803) 722-4975
(903) 722-6018
Mailing address
200 SPRINGTREE DR, COLUMBIA, SC 29223-8614
(803) 722-4975
(803) 722-6018
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
7244
SC
106S00000X
Behavior Technician
17-32172
SC
Other
Enumeration date
04/04/2018
Last updated
09/30/2021
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