Individual
MRS. MARY ETTA CASTLES ABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2805 MILLWOOD AVE, COLUMBIA, SC 29205-1298
(803) 234-8596
Mailing address
1505 BLANDING ST, COLUMBIA, SC 29201-2906
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-18-30002
SC
Other
Enumeration date
06/05/2020
Last updated
06/01/2022
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