Individual
DIANA DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5460 HIGHMARKET ST, GEORGETOWN, SC 29440-9764
(843) 304-5883
Mailing address
5460 HIGHMARKET ST, GEORGETOWN, SC 29440-9764
(843) 304-5883
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
—
172A00000X
Driver
007880024
SC
174200000X
Meals Provider
007880024
SC
253J00000X
Foster Care Agency
007880024
SC
332U00000X
Home Delivered Meals
007880024
SC
343900000X
Non-emergency Medical Transport (VAN)
Primary
007880024
SC
376K00000X
Nurse's Aide
121624
SC
Other
Enumeration date
11/30/2022
Last updated
03/11/2026
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