Individual
MARTIN SEAN ETHERIDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
212 W MCGREGOR ST, PAGELAND, SC 29728-2137
(843) 672-7096
Mailing address
212 W MCGREGOR ST, PAGELAND, SC 29728-2137
(843) 672-7096
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
6059
SC
251S00000X
Community/Behavioral Health Agency
Primary
6059
SC
Other
Enumeration date
12/15/2010
Last updated
03/21/2025
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