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Individual

MR. JOEL ALLYN SOUTHERLIN II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LISW-CP

Contact information

Practice address
3420 PINE BELT RD, COLUMBIA, SC 29204-3129
(803) 691-9861
Mailing address
3420 PINE BELT RD, COLUMBIA, SC 29204-3129
(803) 691-9861

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
T5508
SC

Other

Enumeration date
09/07/2010
Last updated
04/17/2018
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