Individual
ASIA WISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
107 DERRICK ST, NORTH, SC 29112-8464
(803) 226-4356
Mailing address
107 DERRICK ST, NORTH, SC 29112-8464
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
10580
SC
Other
Enumeration date
01/15/2025
Last updated
01/15/2025
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