Individual
JACQUELINE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
204 MARTIN LUTHER KING JR BLVD, DILLON, SC 29536-3304
(843) 774-6591
(843) 774-1409
Mailing address
204 N MLK JR BLVD, DILLON, SC 29536
(843) 774-6591
(843) 774-1409
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
01/04/2013
Last updated
01/04/2013
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