Individual
JENNIFER A DALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC-A
Contact information
Practice address
1911 GADSDEN ST, COLUMBIA, SC 29201-6400
(803) 254-9767
Mailing address
112 IRONCREST WAY, COLUMBIA, SC 29212-0607
(803) 873-1192
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
7040
SC
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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