Healthcare Provider Details

I. General information

NPI: 1083000798
Provider Name (Legal Business Name): ANDREA SARTORI PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2015
Last Update Date: 11/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W 5TH NORTH ST STE 102
SUMMERVILLE SC
29483
US

IV. Provider business mailing address

107 W 5TH NORTH ST STE 102
SUMMERVILLE SC
29483-6446
US

V. Phone/Fax

Practice location:
  • Phone: 843-509-6521
  • Fax: 843-636-3406
Mailing address:
  • Phone: 843-509-6521
  • Fax: 843-636-3406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPS01513
License Number StateRI
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1567
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1567
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: