Individual
LISA MUSTARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT-I
Contact information
Practice address
2016 ASSEMBLY ST, COLUMBIA, SC 29201-2142
(803) 665-6399
Mailing address
509 S BONHAM RD, COLUMBIA, SC 29205-4010
(803) 665-6399
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
4750
SC
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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