Individual
TINA O'BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 RIBAUT RD, BEAUFORT, SC 29902-5400
(843) 524-8899
Mailing address
1050 RIBAUT RD, BEAUFORT, SC 29902-5400
(843) 524-8899
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
225C00000X
Rehabilitation Counselor
—
—
Other
Enumeration date
08/22/2018
Last updated
07/20/2021
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