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NPI Code Detail

MEDICARE: MS. DWANA LOUISE DAVID LPES

MEDICARE: MS. DWANA LOUISE DAVID LPES
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist

General Provider Information

NPI Number : 1154048023
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DWANA LOUISE DAVID LPES
Provider Business Mailing Address
First Line : 812 W MAIN ST
Second Line :
City : ROCK HILL
State : SC
Zip : 29730-3411
Country : US
Telephone Number : 843-617-5749
Fax Number :
Provider Business Practice Location Address
First Line : 2685 CELANESE RD STE 105
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-2994
Country : US
Telephone Number : 803-661-5033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2022
Last Update Date : 10/21/2022

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Directions to “ MS. DWANA LOUISE DAVID LPES” Practice Location

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