Weathers, Kellie Brabham

Weathers, Kellie Brabham is an individual health care provider with primary practice located at 3310 Magnolia St , Orangeburg SC 29115-1466. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Weathers, Kellie Brabham can be contacted via phone (803) 531-6900.

Contact Information

Primary practice address
3310 Magnolia St Orangeburg SC 29115-1466
Phone: (803) 531-6900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1750834040
LBN Legal business name Weathers, Kellie Brabham
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2016
Last updated Aug 5th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1750834040 NPPES
South Carolina MEDICAID 1760596480

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