Individual
MRS. MARISSA JEAN GAMBLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
1300 2ND AVE STE 210, CONWAY, SC 29526-5205
(843) 488-1615
(843) 488-1616
Mailing address
1300 2ND AVE STE 210, CONWAY, SC 29526-5205
(843) 488-1615
(843) 488-1616
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
9610
SC
Other
Enumeration date
01/18/2016
Last updated
01/18/2016
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