Provider Information for 1831773324
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JASMINE OPAL ELROD LISW-CP
Sex: Female
NPI: 1831773324
Last Updated: 2021-05-10
Certification Date: 2021-05-10
Certification Date: 2021-05-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1831773324 | ||||||||
| Enumeration Date | 2021-05-10 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 812 LOCKHURST DR SIMPSONVILLE, SC 29681-3945 United States Phone: 864-884-2506 | Fax: | ||||||||
| Primary Practice Address | 812 LOCKHURST DR SIMPSONVILLE, SC 29681-3945 United States Phone: 864-884-2506 | Fax: | ||||||||
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