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Individual

BRIDGET HOLLIS STATEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D, LPC, CRC

Contact information

Practice address
1031 MIDDLETON ST, ORANGEBURG, SC 29115-4783
(803) 534-4160
Mailing address
1031 MIDDLETON ST, ORANGEBURG, SC 29115-4783
(803) 534-4160
(803) 997-2364

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6569
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PC12181
SC
Enumeration date
05/11/2018
Last updated
05/11/2018
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