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Individual

SHAMESHIA BREONA BENTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
L.M.S.W

Contact information

Practice address
3809 ROSEWOOD DR, COLUMBIA, SC 29205-3533
(803) 786-1844
(803) 754-7783
Mailing address
800 ALEXANDER RD APT 129H, CAYCE, SC 29033-4386
(704) 917-8783

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
101YM0800X
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
101M0800X
COUNSELOR-MENTAL HEALTH
SC
Enumeration date
07/21/2014
Last updated
07/21/2014
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