Individual
TAIVONNA WAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
403 STONY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
Mailing address
403 STONY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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