Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | SC | |
N | 103T00000X | Psychologist | SC | |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | SC | |
Y | 103TC1900X | Counseling Psychologist | SC | |
N | 103TH0100X | Health Service | SC |
NPI | 1114127792 |
---|---|
Provider Name | Dr. Janet Krantz |
First Address | Central, SC 29630-9373 |
Second Address | Central, SC 29630-9373 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2007 |
Last Update Date | 20/07/2007 |