Individual
MADISON MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
(843) 347-3959
Mailing address
3672 CLAY POND VILLAGE LN APT 8, MYRTLE BEACH, SC 29579-7407
(843) 446-7184
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
06/17/2021
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