Individual
SHANE PAUL FLETCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
204 W HILL BLVD BLDG 1000, CHARLESTON AFB, SC 29404-4704
(843) 963-6852
Mailing address
204 W HILL BLVD, CHARLESTON AFB, SC 29404-4704
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904010701
VA
Other
Enumeration date
07/21/2022
Last updated
07/21/2022
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