Healthcare Provider Details

I. General information

NPI: 1528384831
Provider Name (Legal Business Name): PEDIATRIC SCHOOL PSYCHOLOGY: EVALUATION AND CONSULTATION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2010
Last Update Date: 04/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3612 LANDMARK DR SUITE B
COLUMBIA SC
29204-4039
US

IV. Provider business mailing address

3612 LANDMARK DR SUITE B
COLUMBIA SC
29204-4039
US

V. Phone/Fax

Practice location:
  • Phone: 803-309-5231
  • Fax: 803-782-1420
Mailing address:
  • Phone: 803-309-5231
  • Fax: 803-782-1420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number848
License Number StateSC

VIII. Authorized Official

Name: DR. BETSY CHESNO GRIER
Title or Position: PRESIDENT/PSYCHOLOGIST
Credential: PHD, NCSP
Phone: 803-309-5231