Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 6783 | SC |
NPI | 1467720938 |
---|---|
Provider Name | Tamara Hale |
First Address | Sumter, SC 29154-1358 |
Second Address | Sumter, SC 29154-1358 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2011 |
Last Update Date | 12/12/2011 |