Organization
BLANK SPACE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEWELL DE GROOT LPC (PROPRIETOR)
(864) 729-3257
Entity
Organization
Contact information
Practice address
1916 WOODRUFF RD, GREENVILLE, SC 29607-5937
(864) 729-3257
Mailing address
248 SCOTTS BLUFF DR, SIMPSONVILLE, SC 29681-8010
(864) 729-3257
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
06/21/2024
Last updated
06/21/2024
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