Individual
COREA DIONNE RAQUEL WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 S MAIN ST, MARION, SC 29571-4914
(843) 431-1100
Mailing address
PO BOX 1093, MULLINS, SC 29574-1093
(843) 617-1941
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
05/24/2023
Last updated
05/24/2023
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