Individual
ALEXANDRA A BOUTAKOVA-KLINTWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
14323 OCEAN HWY UNIT 4111, PAWLEYS ISLAND, SC 29585-4817
(843) 235-9960
Mailing address
14323 OCEAN HWY UNIT 4111, PAWLEYS ISLAND, SC 29585-4817
(843) 235-9960
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
5691
SC
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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