Individual
TIAERA PAULETTE PRITCHETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
40 BALDWIN AVE, LUGOFF, SC 29078-9406
(803) 408-3262
(803) 408-8895
Mailing address
645 S SEVENTH ST, MC BEE, SC 29101-7101
(843) 335-8291
(843) 335-8731
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
10196
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10196
LISW LIC
SC
Enumeration date
12/04/2012
Last updated
04/19/2013
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