Individual
DALLY NICOLE DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RBT
Contact information
Practice address
4313 RIVER GATE LN, LITTLE RIVER, SC 29566-6828
(910) 545-8353
Mailing address
4313 RIVER GATE LN, LITTLE RIVER, SC 29566-6828
(910) 545-8353
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
SC
Other
Enumeration date
08/21/2017
Last updated
04/26/2024
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