Tami V Leonhardt Phd Llc | |
1904 Sunset Blvd Suite D West Columbia SC 29169-5953 | |
(803) 791-1485 | |
(803) 939-9378 |
Full Name | Tami V Leonhardt Phd Llc |
---|---|
Speciality | Psychologist |
Location | 1904 Sunset Blvd, West Columbia, South Carolina |
Authorized Official Name and Position | Tami V Leonhardt (OWNER) |
Authorized Official Contact | 8037911485 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Tami V Leonhardt Phd Llc 1904 Sunset Blvd Suite D West Columbia SC 29169-5953 Ph: (803) 791-1485 | Tami V Leonhardt Phd Llc 1904 Sunset Blvd Suite D West Columbia SC 29169-5953 Ph: (803) 791-1485 |
NPI Number | 1184883787 |
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Provider Enumeration Date | 06/09/2008 |
Last Update Date | 06/09/2008 |
Medicare PECOS PAC ID | 0547332140 |
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Medicare Enrollment ID | O20080626000108 |
Identifier | Type | State | Issuer |
---|---|---|---|
1184883787 | NPI | - | NPPES |
PSO144 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC0700X | Psychologist - Clinical | 560 (South Carolina) | Primary |
Provider Name | Tami V. Leonhardt |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1255325783 PECOS PAC ID: 9537231139 Enrollment ID: I20080707000586 |
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