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Individual

MRS. HENRIETTA MCCOLLOUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5547 HOWZE RD, CATAWBA, SC 29704-7750
(803) 431-0197
Mailing address
PO BOX 454, CATAWBA, SC 29704-0454
(803) 431-0197

Taxonomy

Speciality
Code
Description
License number
State
2278H0200X
Home Health Certified Respiratory Therapist
Primary
IHCP-1809
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
IHCP-1809
SC
Enumeration date
12/19/2022
Last updated
12/19/2022
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