Individual
MRS. SAMANTHA JO WATERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
216 E MAIN ST, LEXINGTON, SC 29072-3546
(803) 520-8295
Mailing address
216 E MAIN ST, LEXINGTON, SC 29072-3546
(803) 520-8295
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6474
SC
Other
Enumeration date
10/11/2017
Last updated
12/30/2020
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