Individual
LAURA STUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 12TH ST, SUITE C, CAYCE, SC 29033-3204
(803) 252-7004
Mailing address
1300 12TH ST, SUITE C, CAYCE, SC 29033-3204
(803) 252-7004
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
000001
SC
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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