| Jls Phd Llc | |
|
308 Bermuda Towne Row Mount Pleasant SC 29464-8230 | |
| (203) 518-1667 | |
| Not Available |
| Full Name | Jls Phd Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 308 Bermuda Towne Row, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Jaclyn Sousa (CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 2035181667 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jls Phd Llc 308 Bermuda Towne Row Mount Pleasant SC 29464-8230 Ph: () - | Jls Phd Llc 308 Bermuda Towne Row Mount Pleasant SC 29464-8230 Ph: (203) 518-1667 |
| NPI Number | 1770173361 |
|---|---|
| Provider Enumeration Date | 01/19/2021 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770173361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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