Individual
MISS MATRICE SHARNAN ROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 CLAUDE BUNDRICK RD, BLYTHEWOOD, SC 29016-9420
(803) 754-5478
Mailing address
111 ELDERS POND CIR APT 13C, COLUMBIA, SC 29229-8164
(803) 513-0821
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1507
SC
Other
Enumeration date
03/23/2007
Last updated
07/08/2007
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