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NPI Profile for COASTAL PEDIATRIC ASSOCIATES PA in CHARLESTON, SC.
A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Health Service |
103TH0100X | 62 | Psychologist, Clinical |
| NPI Number | 1083110019 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 03/30/2018 | |
| Last updated | 03/30/2018 - About 8 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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COASTAL PEDIATRIC ASSOCIATES, P.A.