| Eminence Image, Llc | |
|
1407 Elmwood Ave Columbia SC 29201-2109 | |
| (910) 853-2184 | |
| Not Available |
| Full Name | Eminence Image, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1407 Elmwood Ave, Columbia, South Carolina |
| Authorized Official Name and Position | Latasha Michelle Bethea (OWNER) |
| Authorized Official Contact | 9108532184 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eminence Image, Llc 1407 Elmwood Ave Columbia SC 29201-2109 Ph: () - | Eminence Image, Llc 1407 Elmwood Ave Columbia SC 29201-2109 Ph: (910) 853-2184 |
| NPI Number | 1235685405 |
|---|---|
| Provider Enumeration Date | 08/28/2016 |
| Last Update Date | 08/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235685405 | NPI | - | NPPES |
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