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Individual

RAVEN SYMONE VAUGHT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LISW-CP

Contact information

Practice address
1330 TAYLOR STREET, COLUMBIA, SC 29220-5869
(803) 272-8055
Mailing address
405 SANDRIDGE RD, LITTLE RIVER, SC 29566-7504
(803) 272-8055

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
15039
SC

Other

Enumeration date
04/16/2022
Last updated
05/08/2022
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