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CRYSTAL MAGAZINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
229 E MAIN ST, MONCKS CORNER, SC 29461-3767
(843) 899-8890
Mailing address
229 E MAIN ST, MONCKS CORNER, SC 29461-3767
(843) 899-8890

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
576000313
SC
Enumeration date
08/18/2017
Last updated
07/21/2022
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