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ANGELA POLITE MACK

Mental Health >> Counselor >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1639726532

Individual Registrant:
 ANGELA POLITE MACK 
Gender: F
Sole Proprietor

Location and contact information for practice:
1109 WHITE HALL RD  YEMASSEE, SC 29945-5319 US
Tel: 843-437-6280  Fax: --

Contact information for business:
5631 SPRING VALLEY RD # 149-2  DALLAS, TX 75254-3169 US
Tel: 843-437-6280  Fax: --

Registration Information:
NPI: 1639726532
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y101YM0800XBehavioral Health & Social Service Providers
Counselor
Mental Health
SC007003996

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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