Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | ||
Y | 103G00000X | Clinical Psychologist | 1134 | SC |
Y | 103TC0700X | Clinical Psychologist | 1134 | SC |
NPI | 1154461291 |
---|---|
Provider Name | Dr. Elizabeth Jane Santa Ana |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 15/10/2020 |