Individual
LISA ANN EARLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
89 OLD TROLLEY RD STE 104, SUMMERVILLE, SC 29485-4957
(843) 955-5780
Mailing address
1015 BLOCKADE RUNNER PKWY, SUMMERVILLE, SC 29485-6317
(808) 354-2588
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
9446
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
435201
—
SC
Enumeration date
09/29/2021
Last updated
02/09/2024
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