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General NPI Number Information
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NPI Number | 1114745080
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Entity Type | Organization
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Legal Business Name | LIDIA CARDONE, PH.D.P.A.
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 400 MAIN ST STE 100A3
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-4624
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Country | US
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Telephone | 843-716-9533
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MAIN ST STE 100A3
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City | HILTON HEAD ISLAND
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State | SC
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Zip | 29926-4624
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Country | US
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Telephone | 843-716-9533
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LIDIA CARDONE
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Credential | PH.D.
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Telephone | 843-816-9533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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