Most Relevant Information
Provider Data
| NPI Number: | 1003414947 |
| Provider Name: | CORETTA CASLEY MASTER |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/13/2020 |
| Last Updated: | 10/13/2020 |
Provider Practice Location
424 GUYTON CT
MULLINS
SC
295746014
Practice Location Phone/Fax
| Phone: | 8434238292 |
| Fax: | 8434238294 |
Provider Mailing Location
PO BOX 1011
MARION
SC
295711011
Provider Mailing Phone/Fax
| Phone: | 8434238292 |
| Fax: | 8434238294 |