Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 839 | SC |
NPI | 1083950950 |
---|---|
Provider Name | Dr. Kevin Irmiter |
First Address | Greer, SC 29650-4766 |
Second Address | Greenville, SC 29605-4270 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2012 |
Last Update Date | 23/03/2017 |