Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 437 | SC |
Y | 103TC0700X | Clinical Psychologist | 437 | SC |
NPI | 1003037805 |
---|---|
Provider Name | Dr. Julie Ann Lipovsky |
First Address | Isle Of Palms, SC 29451-0187 |
Second Address | Isle Of Palms, SC 29451-2343 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 08/07/2007 |