Individual
SHANITA BURGESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
524 DOCTORS CT, CHESTER, SC 29706-8644
(803) 328-9600
Mailing address
524 DOCTORS CT, CHESTER, SC 29706-8644
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
A11960
NC
Other
Enumeration date
02/11/2016
Last updated
02/11/2016
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