Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 2459 | SC |
N | 101YP2500X | Professional Counselor | 2459 | SC |
NPI | 1093805426 |
---|---|
Provider Name | Dr. W. Scott Mcbroom |
First Address | Charleston, SC 29407-9608 |
Second Address | Charleston, SC 29407-3947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/10/2006 |
Last Update Date | 08/07/2007 |