Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003235029 |
---|---|
Provider Name | Ashley Chapman |
First Address | Columbia, SC 29203-6818 |
Second Address | Columbia, SC 29203-6818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 08/04/2014 |