Individual
NEAL JACKSON VERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.S.W
Contact information
Practice address
11 RICHLAND MEDICAL PARK DR, COLUMBIA, SC 29203-6863
(803) 434-1251
Mailing address
1116 OLYMPIA AVE APT B, COLUMBIA, SC 29201-4426
(803) 238-9417
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8507
SC
Other
Enumeration date
07/26/2006
Last updated
07/08/2007
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