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331 E Main St Ste 200 Rock Hill SC 29730-5384 | |
| (833) 991-2368 | |
| (929) 384-7193 |
| Full Name | |
|---|---|
| Speciality | Behavior Analyst |
| Location | 331 E Main St Ste 200, Rock Hill, South Carolina |
| Authorized Official Name and Position | Benjamin Selzer (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8333847193 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
331 E Main St Ste 200 Rock Hill SC 29730-5384 Ph: (833) 991-2368 | 331 E Main St Ste 200 Rock Hill SC 29730-5384 Ph: (833) 991-2368 |
| NPI Number | 1033790951 |
|---|---|
| Provider Enumeration Date | 04/21/2021 |
| Last Update Date | 09/27/2021 |
| Certification Date | 09/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033790951 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
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