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General NPI Number Information
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NPI Number | 1285331348
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Entity Type | Organization
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Legal Business Name | INSIEMI PSYCHOTHERAPY
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Dates
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Enumeration Date | 02/09/2023
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Last Update Date | 02/16/2023
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Provider Practice Location Address
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Address Line | 508 DEWY MEADOWS DR
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City | TAYLORS
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State | SC
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Zip | 29687-3573
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Country | US
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Telephone | 631-806-0919
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Fax |
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Provider Business Mailing Address
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Address Line | 508 DEWY MEADOWS DR
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City | TAYLORS
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State | SC
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Zip | 29687-3573
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Country | US
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Telephone | 631-806-0919
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | JENNIFER QUAGLIARIELLO
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Credential | LCSW, LISW-CP
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Telephone | 631-806-0919
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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