Healthcare Provider Details

I. General information

NPI: 1225258361
Provider Name (Legal Business Name): LUCIA T HOROWITZ PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1041 JOHNNIE DODDS BLVD SUITE 14B
MT PLEASANT SC
29464
US

IV. Provider business mailing address

1041 JOHNNIE DODDS BLVD SUITE 14B
MT PLEASANT SC
29464
US

V. Phone/Fax

Practice location:
  • Phone: 843-884-3888
  • Fax: 843-884-8124
Mailing address:
  • Phone: 843-884-3888
  • Fax: 843-884-8124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number296
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: