Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 9919 | SC |
NPI | 1003181827 |
---|---|
Provider Name | Andrea Claire D'andrea |
First Address | Charleston, SC 29414-9149 |
Second Address | Charleston, SC 29407-6065 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2012 |
Last Update Date | 25/07/2013 |