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General NPI Number Information
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NPI Number | 1558042739
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Entity Type | Organization
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Legal Business Name | SEEDS OF DISCOVERY THERAPY, WELLNESS & CONSULTATION SERVICES LLC
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Dates
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Enumeration Date | 07/31/2023
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Last Update Date | 07/31/2023
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Provider Practice Location Address
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Address Line | 1120 SPARKLEBERRY LANE EXT STE B
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City | COLUMBIA
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State | SC
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Zip | 29223-7078
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Country | US
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Telephone | 803-967-9313
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Fax |
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Provider Business Mailing Address
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Address Line | 4920 HARDSCRABBLE ROAD APT 405
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City | COLUMBIA
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State | SC
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Zip | 29229-9368
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Country | US
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Telephone | 803-967-9313
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Fax | 803-769-7486
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MS. MICHELLE J WHITLOW-BLANDING
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Credential | LPC
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Telephone | 803-967-9313
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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