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General NPI Number Information
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NPI Number | 1235805896
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Entity Type | Organization
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Legal Business Name | THRIVE ANXIETY AND WELLNESS LLC
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 08/23/2021
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Provider Practice Location Address
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Address Line | 408 OVERLOOK DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7500
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Country | US
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Telephone | 803-586-9225
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Fax |
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Provider Business Mailing Address
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Address Line | 408 OVERLOOK DR
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City | BLYTHEWOOD
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State | SC
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Zip | 29016-7500
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Country | US
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Telephone | 803-586-9225
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOLOGIST
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Name | DEBRA BRIGHT HUSS
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Credential | PH.D.
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Telephone | 803-586-9225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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