Individual
MS. CATHY A LARGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSS
Contact information
Practice address
2611 LIBERTY HILL RD, CAMDEN, SC 29020-1871
(803) 432-5323
(803) 713-3978
Mailing address
215 N MAGNOLIA ST, SUMTER, SC 29150-4943
(803) 775-9364
(803) 773-6615
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3338
—
SC
Enumeration date
09/01/2011
Last updated
09/01/2011
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