Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1365 | SC |
Y | 103T00000X | Psychologist | 1365 | SC |
N | 103TS0200X | School Psychologist | 277037 | SC |
NPI | 1033577465 |
---|---|
Provider Name | Susan Craft Astary |
First Address | Florence, SC 29501-5585 |
Second Address | Florence, SC 29501-5585 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2016 |
Last Update Date | 30/01/2016 |