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General NPI Number Information
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NPI Number | 1437642824
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Entity Type | Organization
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Legal Business Name | EMBRACE CLINICAL SERVICES LLC
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 06/16/2018
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Provider Practice Location Address
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Address Line | 331 EAST MAIN STREEST
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City | ROCK HILL
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State | SC
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Zip | 29730
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Country | US
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Telephone | 803-529-0910
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Fax |
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Provider Business Mailing Address
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Address Line | 745 ELDERBERRY LN
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City | COLUMBIA
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State | SC
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Zip | 29229-6836
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Country | US
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Telephone | 803-529-0910
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICIAN
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Name | MS. DIANA ALEXANDRIA MURRAY
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Credential | LISW-CP/S
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Telephone | 803-529-0910
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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 | SC
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