Individual
MRS. BEVERLY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9367 TWO NOTCH RD, SUITE C2, COLUMBIA, SC 29223-6442
(404) 956-2691
(803) 661-1093
Mailing address
9367 TWO NOTCH RD, SUITE C2, COLUMBIA, SC 29223-6442
(404) 956-2691
(803) 661-1093
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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