Individual
STACI JILL QUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED. M.A. LPC
Contact information
Practice address
2113 ADAMS GROVE STE 110, COLUMBIA, SC 29203
(803) 256-1737
Mailing address
1809 HEYWARD ST., COLUMBIA, SC 29205
(803) 414-5591
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
5811
SC
Other
Enumeration date
03/13/2013
Last updated
12/15/2014
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