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General NPI Number Information
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NPI Number | 1306245444
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Entity Type | Individual
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Provider Name | KERRY A. LOPE PSY. D.
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Gender | Female
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Dates
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Enumeration Date | 08/14/2014
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Last Update Date | 08/14/2014
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Provider Practice Location Address
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Address Line | 3750 DORCHESTER RD
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-7567
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Country | US
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Telephone | 843-745-7113
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Fax | 843-529-3906
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Provider Business Mailing Address
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Address Line | 3750 DORCHESTER RD
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405-7567
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Country | US
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Telephone | 843-745-7113
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Fax | 843-529-3906
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 267447
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License Number State | SC
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