Individual
LAWANDA SHAVONTE MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
208 KING ST, CAMDEN, SC 29020-4720
(803) 432-6902
Mailing address
1910 NEARVIEW AVE, COLUMBIA, SC 29223-3730
(803) 915-0621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
09/08/2023
Last updated
09/08/2023
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