| Martha K Stewart | |
|
525 S Dargan St Florence SC 29506-2549 | |
| (843) 407-5419 | |
| (843) 407-7274 |
| Full Name | Martha K Stewart |
|---|---|
| Speciality | Counselor - Professional |
| Location | 525 S Dargan St, Florence, South Carolina |
| Authorized Official Name and Position | Martha Kay Stewart (OWNER) |
| Authorized Official Contact | 8434075419 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Martha K Stewart 525 S Dargan St Florence SC 29506-2549 Ph: (843) 407-5419 | Martha K Stewart 525 S Dargan St Florence SC 29506-2549 Ph: (843) 407-5419 |
| NPI Number | 1215475884 |
|---|---|
| Provider Enumeration Date | 02/03/2017 |
| Last Update Date | 06/16/2020 |
| Certification Date | 06/16/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215475884 | NPI | - | NPPES |
| GP794Z | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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