Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 1174957559 | SC |
NPI | 1003461781 |
---|---|
Provider Name | Ms. Ruby Chandler Billings |
First Address | York, SC 29745-1734 |
Second Address | York, SC 29745-0770 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2019 |
Last Update Date | 08/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1174957559 | (05) | SC |