Doctor Name: | MARY A EVERETTE |
NPI Number: | 1003984881 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 3601c Meeting Street Rd North Charleston, SC - 294057715 |
Business Phone Number: | 8437406136 |
Business Fax Number: | |
Mailing Address: | 3601c Meeting Street Rd, NORTH CHARLESTON |
State: | SC |
Postal Code: | 294057715 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |