Dr. Sudie E Back, PhD
Psychologist, Clinical in Charleston, SC. Individual provider (NPI-1).
NPI number1164478723
StatusActive
Last updated in NPPESOct 29, 2020
Details
- NPI
- 1164478723
- Entity type
- Individual (NPI-1)
- Name
- Dr. Sudie E Back
- Credential
- PhD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 25, 2006
- Certification date
- Oct 29, 2020
- Last updated
- Oct 29, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 1024 | SC | Yes |
Practice location
125 Doughty StreetSuite 120
Charleston, SC 29425
Phone 843-792-5215 · Fax 843-792-0528
Mailing address
Po Box 751461Charlotte, NC 28275-1461
Phone 843-792-6200
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