Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 6134 | SC |
NPI | 1003212853 |
---|---|
Provider Name | Yvette Jeffries |
First Address | Orangeburg, SC 29115-4944 |
Second Address | Orangeburg, SC 29115-4944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/11/2014 |
Last Update Date | 06/11/2014 |