Individual
MS. MICHELLE D. TRASK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.W.
Contact information
Practice address
1821 PICKENS ST, COLUMBIA, SC 29201-2630
(803) 404-2064
Mailing address
223 S BONHAM RD, COLUMBIA, SC 29205-4004
(803) 404-2064
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9215
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011543600
—
MD
Enumeration date
11/01/2006
Last updated
10/05/2012
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