Individual
MADONNA JEAN LAROCQUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LISW-CP
Contact information
Practice address
1604 PHEASANT POINTE CT, MYRTLE BEACH, SC 29588-6299
(774) 488-4225
Mailing address
1604 PHEASANT POINTE CT, MYRTLE BEACH, SC 29588-6299
(774) 488-4225
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12436
SC
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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