Individual
MR. WALLACE JERRY WALDROP JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT
Contact information
Practice address
2917 MILLWOOD AVE BLDG B, COLUMBIA, SC 29205-1334
(803) 814-6218
(855) 490-9560
Mailing address
2917 MILLWOOD AVE BLDG B, COLUMBIA, SC 29205-1334
(803) 814-6218
(855) 490-9560
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
1746
NC
106H00000X
Marriage & Family Therapist
Primary
6995
SC
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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