Individual
TAMARA L SIDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
301 ANDERSON ST, GREENVILLE, SC 29601-4022
(864) 283-0637
(864) 283-0638
Mailing address
325 MARBLE LN, BOILING SPRINGS, SC 29316-7437
(864) 508-2105
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5470
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4982
—
SC
Enumeration date
11/20/2012
Last updated
11/20/2012
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