| Intrepid Integrative Solutions, Inc | |
|
229 Johnston St Rock Hill SC 29730-3579 | |
| (803) 947-9231 | |
| Not Available |
| Full Name | Intrepid Integrative Solutions, Inc |
|---|---|
| Speciality | Psychologist |
| Location | 229 Johnston St, Rock Hill, South Carolina |
| Authorized Official Name and Position | Whitney Danso (FOUNDER) |
| Authorized Official Contact | 8039479231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Intrepid Integrative Solutions, Inc 229 Johnston St Rock Hill SC 29730-3579 Ph: () - | Intrepid Integrative Solutions, Inc 229 Johnston St Rock Hill SC 29730-3579 Ph: (803) 947-9231 |
| NPI Number | 1346875556 |
|---|---|
| Provider Enumeration Date | 03/09/2020 |
| Last Update Date | 05/08/2020 |
| Certification Date | 05/08/2020 |
| Medicare PECOS PAC ID | 2961816681 |
|---|---|
| Medicare Enrollment ID | O20210120002567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346875556 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Whitney Y Danso |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720611833 PECOS PAC ID: 3870907595 Enrollment ID: I20210120002666 |
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