Doctor Name: | MR. GARY DOUGLAS CABBAGE |
NPI Number: | 1548229289 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 4606 |
Business Practice Address: | 101 S Catherine St Walhalla, SC - 296912608 |
Business Phone Number: | 8647236690 |
Business Fax Number: | 8648881310 |
Mailing Address: | Po Box 533, WALHALLA |
State: | SC |
Postal Code: | 296910533 |
Phone Number: | 8647236690 |
Fax Number: | 8648881310 |
NPI Enumeration Date: | 03/21/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 4606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |