Individual
PROF. NELLIE PHOENIX-MCCOY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BT
Contact information
Practice address
563 WYNFIELD FOREST DR, SUMMERVILLE, SC 29485-7546
(843) 532-6444
Mailing address
PO BOX 171, LADSON, SC 29456-0171
(843) 532-6444
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/07/2024
Last updated
11/07/2024
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