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General NPI Number Information
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NPI Number | 1659137248
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Entity Type | Organization
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Legal Business Name | PPI THERAPY AND CONSULTING FIRM, LLC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 419 SE MAIN ST STE 205
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City | SIMPSONVILLE
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State | SC
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Zip | 29681-2675
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Country | US
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Telephone | 971-268-8939
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Fax | 864-288-7701
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Provider Business Mailing Address
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Address Line | 2607 WOODRUFF RD STE. E #205
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City | SIMPSONVILLE
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State | SC
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Zip | 29681
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Country | US
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Telephone | 971-268-8939
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Fax | 864-288-7701
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. JOY MAULDIN
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Credential | PSY.D
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Telephone | 971-268-8939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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