Individual
KERISTEN MAZYCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
1632 WAYAH DR, CHARLESTON, SC 29414-5829
(843) 813-2957
Mailing address
1632 WAYAH DR, CHARLESTON, SC 29414-5829
(843) 813-2957
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9165
SC
Other
Enumeration date
11/27/2020
Last updated
11/27/2020
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