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General NPI Number Information
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NPI Number | 1558822965
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Entity Type | Individual
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Provider Name | MS. JOY WYNETTA PARKS COBB
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Gender | Female
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 03/28/2019
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Provider Practice Location Address
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Address Line | 2715 COLONIAL DR STE 100
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City | COLUMBIA
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State | SC
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Zip | 29203-6818
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Country | US
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Telephone | 803-898-4777
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Fax |
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Provider Business Mailing Address
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Address Line | 304 THORNFIELD RD
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City | COLUMBIA
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State | SC
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Zip | 29229-9147
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Country | US
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Telephone | 843-810-7404
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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