Individual
ETHEL BLAKE BELLAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
Mailing address
164 WACCAMAW MEDICAL PARK DR, CONWAY, SC 29526-8903
(843) 347-5060
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
1022
SC
101YP2500X
Professional Counselor
Primary
1175
SC
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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