Individual
SHAWNA FORTSON PRINCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1547 PARKWAY, SUITE 200, GREENWOOD, SC 29646-4081
(864) 223-8331
Mailing address
1547 PARKWAY, SUITE 100, GREENWOOD, SC 29646-4081
(864) 229-7120
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
421504
—
SC
Enumeration date
08/21/2006
Last updated
07/09/2007
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