Individual
MAVIS MANIGAULT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3618 ASHLEY PHOSPHATE RD STE 7, NORTH CHARLESTON, SC 29418-8586
(843) 608-7041
(843) 800-2254
Mailing address
PO BOX 40331, NORTH CHARLESTON, SC 29423-0331
(843) 530-2411
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
SC
374U00000X
Home Health Aide
—
SC
376K00000X
Nurse's Aide
—
—
385H00000X
Respite Care
—
SC
Other
Enumeration date
07/11/2021
Last updated
07/11/2021
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