| Magnolia Psychiatry Llc | |
|
1001 Anna Knapp Ext Mt Pleasant SC 29464-5412 | |
| (843) 256-3326 | |
| Not Available |
| Full Name | Magnolia Psychiatry Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1001 Anna Knapp Ext, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Alexis Angel Lagtapon Guevara (CHILD AND ADOLESCENT PSYCHIATRIST) |
| Authorized Official Contact | 8432563326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Psychiatry Llc 1001 Anna Knapp Ext Mt Pleasant SC 29464-5412 Ph: (843) 256-3326 | Magnolia Psychiatry Llc 1001 Anna Knapp Ext Mt Pleasant SC 29464-5412 Ph: (843) 256-3326 |
| NPI Number | 1093575722 |
|---|---|
| Provider Enumeration Date | 03/20/2024 |
| Last Update Date | 03/20/2024 |
| Certification Date | 03/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093575722 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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