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NPI Code Detail

MEDICARE: CHERIA DANE' LIVINGSTON

MEDICARE: CHERIA DANE' LIVINGSTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1366475535
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERIA DANE' LIVINGSTON
Provider Business Mailing Address
First Line : 5928 HIGHWAY 905
Second Line :
City : CONWAY
State : SC
Zip : 29526-7170
Country : US
Telephone Number : 843-365-2465
Fax Number :
Provider Business Practice Location Address
First Line : 164 WACCAMAW MEDICAL PARK DR
Second Line :
City : CONWAY
State : SC
Zip : 29526-8903
Country : US
Telephone Number : 843-347-5060
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2006
Last Update Date : 07/08/2007

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Directions to “ CHERIA DANE' LIVINGSTON ” Practice Location

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