Mha
Counselor, Mental Health in Blythewood, SC. Organization (NPI-2).
NPI number1285962886
StatusActive
Last updated in NPPESNov 20, 2009
Details
- NPI
- 1285962886
- Entity type
- Organization (NPI-2)
- Legal business name
- Mha
- Organization subpart
- No
- Enumeration date
- Nov 20, 2009
- Last updated
- Nov 20, 2009
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 101ym0800x | SC | Yes |
Practice location
200 Claude Bundrick RdBlythewood, SC 29016-9420
Phone 803-786-5478
Mailing address
419 Torwood DrColumbia, SC 29203
Phone 803-714-0948
Authorized official
Carlissa Y Goodwin
Care Provider
8037359680
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