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Thread-Topic: Response via eform 100009 - VSP Application
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Subject: Response via eform 100009 - VSP Application
Date: Thu, 6 Oct 2016 13:13:43 -0400
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<APP>WORKFLOW
<TEMPLATEID>350</TEMPLATEID>
<PREFIX></PREFIX>
<FIRST>Ellison</FIRST>
<MIDDLE></MIDDLE>
<LAST>Kirby</LAST>
<ADDR2>Suite 201</ADDR2>
<CITY>Columbia</CITY>
<STATE>SC</STATE>
<ZIP>29204</ZIP>
<EMAIL>sasc@stsm.org</EMAIL>
<PHONE_B>803-790-8208</PHONE_B>
<ADDR1>3830 Forest Drive</ADDR1>
<TITLE>Sexual Assault Services Coordinator</TITLE>
<ORGANIZATION>Sexual Trauma Services of the Midlands</ORGANIZATION>
<WFUD_DateHire>07/01/2016</WFUD_DateHire>
<WFUD_County>Richland</WFUD_County>
<WFUD_Muncipality></WFUD_Muncipality>
<WFUD_JudCircuit>5th Cir</WFUD_JudCircuit>
<WFUD_Employment>Private/Non Profit Organization</WFUD_Employment>
<WFUD_Credentialing>Basic VSP</WFUD_Credentialing>
<ADDL_PEOPLE>
<PREFIX></PREFIX>
<FIRST>Melanie</FIRST>
<MIDDLE></MIDDLE>
<LAST>Snipes</LAST>
<EMAIL>dcs@stsm.org</EMAIL>
<ORGANIZATION>Sexual Trauma Services of the Midlands</ORGANIZATION>
<PHONE_B>803-790-8208</PHONE_B>
<TITLE>Director of Crisis Services</TITLE>
</ADDL_PEOPLE>
<SUBJECT></SUBJECT>
<CUSTOM1>96.10.98.106</CUSTOM1>
<MSG>

</MSG>

</APP>