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General NPI Number Information
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NPI Number | 1306400866
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Entity Type | Organization
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Legal Business Name | CAROLINA ATTACHMENT AND TRAUMA SERVICES
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 409 LUCERNE DR
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City | SPARTANBURG
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State | SC
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Zip | 29302-3215
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Country | US
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Telephone | 217-316-1396
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Fax |
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Provider Business Mailing Address
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Address Line | 409 LUCERNE DR
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City | SPARTANBURG
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State | SC
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Zip | 29302-3215
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Country | US
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Telephone | 217-316-1396
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAREN BUCKWALTER
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Credential | LCSW
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Telephone | 217-316-1396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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