Provider Demographics
NPI:1255603163
Name:DRIGGERS, MARK D (MA)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:D
Last Name:DRIGGERS
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2894 HICKS RD
Mailing Address - Street 2:
Mailing Address - City:TURBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29162-9105
Mailing Address - Country:US
Mailing Address - Phone:843-736-0112
Mailing Address - Fax:
Practice Address - Street 1:510 E CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4312
Practice Address - Country:US
Practice Address - Phone:843-332-4156
Practice Address - Fax:843-332-4159
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)