Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4585 | SC |
N | 103TF0000X | Family Psychologist | 4585 | SC |
N | 103TM1800X | Intellectual & Developmental Disabilities | 4585 | SC |
N | 103TP2701X | Group Psychotherapist | 4585 | SC |
Y | 103TS0200X | School Psychologist | 4585 | SC |
NPI | 1225308448 |
---|---|
Provider Name | Thelvanesa Murphy |
First Address | Columbia, SC 29223-3232 |
Second Address | Columbia, SC 29223-3232 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2012 |
Last Update Date | 04/01/2012 |