Individual
JALISSA NEWTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
77 HAZZARD CREEK VLG STE C, RIDGELAND, SC 29936-8266
(843) 645-7700
Mailing address
PO BOX 205, ESTILL, SC 29918-0205
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7247
SC
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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