Healthcare Provider Details

I. General information

NPI: 1952254534
Provider Name (Legal Business Name): DEWANDA COARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2026
Last Update Date: 02/16/2026
Certification Date: 02/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 OAKLAND AVE
ROCK HILL SC
29730-3552
US

IV. Provider business mailing address

926 OAKLAND AVE
ROCK HILL SC
29730-3552
US

V. Phone/Fax

Practice location:
  • Phone: 704-953-7959
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8448
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: