Individual
MADELINE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1451 RETAIL ROW, HARTSVILLE, SC 29550-4258
(800) 805-6989
Mailing address
464 ELMORE RD, BISHOPVILLE, SC 29010-7729
(803) 229-5681
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/14/2024
Last updated
10/14/2024
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