Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1321 | SC |
Y | 103T00000X | Psychologist | 1321 | SC |
NPI | 1013256932 |
---|---|
Provider Name | Ms. Sheresa Christine Christopher |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-8908 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2013 |
Last Update Date | 11/12/2014 |