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NPI Code Detail

MEDICARE: JANE W LAWTHER PH.D.

MEDICARE: JANE W LAWTHER PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor81SC
2101YP2500XProfessional Counselor953SC

General Provider Information

NPI Number : 1841564994
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANE W LAWTHER PH.D.
Provider Business Mailing Address
First Line : 1731 KENNERLY RD
Second Line :
City : IRMO
State : SC
Zip : 29063-8692
Country : US
Telephone Number : 803-781-1313
Fax Number :
Provider Business Practice Location Address
First Line : 2625 RUTLEDGE ST
Second Line :
City : COLUMBIA
State : SC
Zip : 29204-2520
Country : US
Telephone Number : 803-799-0144
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 03/06/2012

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