Individual
JESSICA LYN DEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3969 SOUTHEASTERN WAY, WEST COLUMBIA, SC 29169-2442
(803) 851-4049
Mailing address
7837 EXETER LN, COLUMBIA, SC 29223-2519
(315) 775-6054
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7738
SC
101YP2500X
Professional Counselor
9089
SC
Other
Enumeration date
09/03/2021
Last updated
11/04/2025
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