Individual
SANDRA JETER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4206 N MAIN ST, COLUMBIA, SC 29203-5864
(803) 786-2121
(803) 786-2124
Mailing address
PO BOX 3788, COLUMBIA, SC 29230-3788
(803) 733-5969
(803) 217-0026
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4857
SC
Other
Enumeration date
09/26/2014
Last updated
09/26/2014
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