Doctor Name: | ELLEN MABE |
NPI Number: | 1659785954 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 10797 |
Business Practice Address: | 212 3rd St Cheraw, SC - 295202648 |
Business Phone Number: | 8435370961 |
Business Fax Number: | 8435370908 |
Mailing Address: | Po Box 1090, HARTSVILLE |
State: | SC |
Postal Code: | 295511090 |
Phone Number: | 8438570111 |
Fax Number: | 8438570206 |
NPI Enumeration Date: | 06/13/2014 |
NPI Last Update Date: | 10/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 10797 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |