Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | P014129 | NC |
NPI | 1003226788 |
---|---|
Provider Name | Kylie Rebecca Scolaro-Conti |
First Address | Greenville, SC 29615-4188 |
Second Address | Hayesville, NC 28904-7740 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2014 |
Last Update Date | 30/09/2019 |