Individual
KEVIN M CIBOROWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 234-8094
Mailing address
662 SUNNY POND LN, AYNOR, SC 29511-4690
(631) 806-8432
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/05/2020
Last updated
11/18/2020
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