Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 5776 | SC |
NPI | 1003155789 |
---|---|
Provider Name | Lakyn Bendle |
First Address | Florence, SC 29501-2808 |
Second Address | Florence, SC 29501-2808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2013 |
Last Update Date | 10/05/2018 |