Healthcare Provider Details

I. General information

NPI: 1144666389
Provider Name (Legal Business Name): FLOERNCE SCHOOL DISTRIC #1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2013
Last Update Date: 05/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 OLIVIA LN
EFFINGHAM SC
29541-4450
US

IV. Provider business mailing address

2323 OLIVIA LN
EFFINGHAM SC
29541-4450
US

V. Phone/Fax

Practice location:
  • Phone: 843-617-9908
  • Fax:
Mailing address:
  • Phone: 843-617-9908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name: MRS. ANNETTE WARDY
Title or Position: BEHAVIORAL INTERVENTIST
Credential:
Phone: 803-664-8448