Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 21189594 | OH |
Y | 103TS0200X | School Psychologist | 545684 | SC |
NPI | 1013374776 |
---|---|
Provider Name | Mrs. Angela Geddes |
First Address | Charleston, SC 29414-5006 |
Second Address | Charleston, SC 29414-5006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2016 |
Last Update Date | 01/08/2019 |