Individual
PRISCILLA L. LAVISCOUNT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
125 E CHEVES ST, FLORENCE, SC 29506-2526
(843) 317-4073
(843) 317-4096
Mailing address
125 E CHEVES ST, FLORENCE, SC 29506-2526
(843) 661-4718
(843) 664-0582
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1205925567
—
SC
Enumeration date
01/31/2023
Last updated
01/31/2023
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