Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 1358 | SC |
Y | 103TC0700X | Clinical Psychologist | 1358 | SC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1358 | SC |
NPI | 1104296102 |
---|---|
Provider Name | Claire Carpenter Phillips |
First Address | Columbia, SC 29229-8400 |
Second Address | Columbia, SC 29229-8400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2015 |
Last Update Date | 02/10/2015 |