Individual
MR. JAY SPATEHOLTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
96 WISTERIA RD, GOOSE CREEK, SC 29445-3495
(843) 867-6133
Mailing address
96 WISTERIA RD, GOOSE CREEK, SC 29445-3495
(843) 867-6133
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
11/20/2023
Last updated
11/20/2023
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