Individual
KEITH DERELL OGLESBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS,CAC
Contact information
Practice address
355 WOODRUFF RD, SUITE 104, GREENVILLE, SC 29607-3429
(864) 286-1500
(864) 234-8255
Mailing address
355 WOODRUFF RD, SUITE 104, GREENVILLE, SC 29607-3429
(864) 286-1500
(864) 234-8255
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
10/24/2011
Last updated
10/24/2011
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