Individual
MS. MARDI LEE LUOMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, LAC
Contact information
Practice address
506 SAINT JAMES AVE, GOOSE CREEK, SC 29445-2793
(843) 291-2311
Mailing address
3004 MARINERS WAY, MONCKS CORNER, SC 29461-3208
(843) 291-2311
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
305
SC
101YP2500X
Professional Counselor
Primary
6877
SC
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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