Individual
JEANNE RAE RECORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
49 PENNINGTON DR STE C, BLUFFTON, SC 29910-9014
(843) 384-4994
Mailing address
49 PENNINGTON DR STE C, BLUFFTON, SC 29910-9014
(843) 384-4994
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
6656
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000
NONE
—
Enumeration date
03/07/2020
Last updated
03/07/2020
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