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General NPI Number Information
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NPI Number | 1659554616
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Entity Type | Individual
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Provider Name | CATHERINE VOS LISW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 12/13/2007
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Provider Practice Location Address
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Address Line | 166 STONERIDGE DR SUITE 100
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City | COLUMBIA
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State | SC
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Zip | 29210-8239
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Country | US
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Telephone | 180-340-0117
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Fax |
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Provider Business Mailing Address
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Address Line | 220 ALICE DR
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City | CHAPIN
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State | SC
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Zip | 29036-9507
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Country | US
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Telephone | 180-344-6276
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 7322
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License Number State | SC
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