Most Relevant Information
Provider Data
| NPI Number: | 1003590340 |
| Provider Name: | JERRY LEE ALLRED LISW-CP |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 6824 |
Most Important Dates
| Enumeration Date: | 06/14/2023 |
| Last Updated: | 06/14/2023 |
Provider Practice Location
11 CROSSWELL DR
SUMTER
SC
291503611
Practice Location Phone/Fax
| Phone: | 8038036511 |
| Fax: |
Provider Mailing Location
11 CROSSWELL DR
SUMTER
SC
291503611
Provider Mailing Phone/Fax
| Phone: | 8036511300 |
| Fax: | 8037746442 |