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General NPI Number Information
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NPI Number | 1619845633
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Entity Type | Organization
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Legal Business Name | SOARING MINDS EVALUATIONS AND SUPPORT
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Dates
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Enumeration Date | 10/29/2025
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Last Update Date | 10/29/2025
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Provider Practice Location Address
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Address Line | 281 PEMBERLY BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-7780
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Country | US
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Telephone | 843-474-6560
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Fax |
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Provider Business Mailing Address
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Address Line | 281 PEMBERLY BLVD
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City | SUMMERVILLE
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State | SC
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Zip | 29486-7780
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Country | US
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Telephone | 412-719-4839
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHO-ED SPECIALIST
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Name | JACQUILYN GAITHER
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Credential | ED.S, LPES
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Telephone | 843-474-6560
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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 |
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License Number State |
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