Magnolia Psychiatry LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Mt Pleasant, SC. Organization (NPI-2).
NPI number1093575722
StatusActive
Last updated in NPPESMar 20, 2024
Details
- NPI
- 1093575722
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Psychiatry LLC
- Organization subpart
- No
- Enumeration date
- Mar 20, 2024
- Certification date
- Mar 20, 2024
- Last updated
- Mar 20, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
1001 Anna Knapp ExtMt Pleasant, SC 29464-5412
Phone 843-256-3326
Mailing address
1001 Anna Knapp ExtMt Pleasant, SC 29464-5412
Phone 843-256-3326
Authorized official
Alexis Angel Lagtapon Guevara
Child And Adolescent Psychiatrist
8432563326
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