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General NPI Number Information
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NPI Number | 1326846254
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Entity Type | Organization
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Legal Business Name | SELF INSPIRED SOLUTIONS LLC
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Dates
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Enumeration Date | 03/05/2025
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 13455 E WADE HAMPTON BLVD STE 17
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City | GREER
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State | SC
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Zip | 29651-6276
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Country | US
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Telephone | 864-551-2384
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Fax |
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Provider Business Mailing Address
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Address Line | 13455 E WADE HAMPTON BLVD STE 17
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City | GREER
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State | SC
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Zip | 29651-6276
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Country | US
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Telephone | 864-551-2384
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Fax |
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Authorized Official
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Title or Position | OWNER/NP
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Name | SHATARRA SALLEY
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Credential | APRN,FNP-BC,PMHNP-BC
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Telephone | 843-344-5709
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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