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General NPI Number Information
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NPI Number | 1376259382
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Entity Type | Organization
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Legal Business Name | PATH TO DISCOVERY LLC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 1220 PICKENS ST
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City | COLUMBIA
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State | SC
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Zip | 29201-3428
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Country | US
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Telephone | 803-760-2932
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Fax |
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Provider Business Mailing Address
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Address Line | 322 BLOOMSBURY CIR
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City | CAMDEN
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State | SC
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Zip | 29020-7958
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Country | US
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Telephone | 803-760-2932
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DANIELLE R. MARX
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Credential | LISW-CP
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Telephone | 903-760-2932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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