| Bianca Jardin Phd Llc | |
|
1050 Johnnie Dodds Blvd, #2381 Mt Pleasant SC 29465-2801 | |
| (812) 401-0941 | |
| (843) 480-9579 |
| Full Name | Bianca Jardin Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1050 Johnnie Dodds Blvd, #2381, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Bianca Jardin (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8124010941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bianca Jardin Phd Llc 1050 Johnnie Dodds Blvd, # 2381 Mt Pleasant SC 29465-2381 Ph: (812) 401-0941 | Bianca Jardin Phd Llc 1050 Johnnie Dodds Blvd, #2381 Mt Pleasant SC 29465-2801 Ph: (812) 401-0941 |
| NPI Number | 1033653910 |
|---|---|
| Provider Enumeration Date | 12/12/2016 |
| Last Update Date | 08/01/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 6406131093 |
|---|---|
| Medicare Enrollment ID | O20170322001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033653910 | NPI | - | NPPES |
| PG0176 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1285 (South Carolina) | Primary |
| Provider Name | Bianca F Jardin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285064956 PECOS PAC ID: 4486884566 Enrollment ID: I20140312000199 |
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