Individual
MRS. REGINA SULLIVAN DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AA, CPSS, CPRC
Contact information
Practice address
3937 SUNSET BLVD, SUITE E, COLUMBIA, SC 29169-4302
(803) 567-3059
(800) 290-8136
Mailing address
3937 SUNSET BLVD, SUITE E, COLUMBIA, SC 29169-4302
(803) 567-3059
(800) 290-8136
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2736403
SC
Other
Enumeration date
05/01/2019
Last updated
05/01/2019
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