Magnolia Psychological Services LLC
Psychologist, Counseling in Mt Pleasant, SC. Organization (NPI-2).
NPI number1629633870
StatusActive
Last updated in NPPESJun 11, 2019
Details
- NPI
- 1629633870
- Entity type
- Organization (NPI-2)
- Legal business name
- Magnolia Psychological Services LLC
- Organization subpart
- No
- Enumeration date
- May 3, 2019
- Last updated
- Jun 11, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC1900X | Psychologist, Counseling | – | – | Yes |
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | |
| 261QM0855X | Clinic/Center, Adolescent and Children Mental Health | – | – |
Practice location
1124 Park West Blvd Ste 202Mt Pleasant, SC 29466-7158
Phone 843-284-6389
Mailing address
1124 Park West Blvd Ste 202Mt Pleasant, SC 29466-7158
Phone 843-284-6389
Authorized official
Kelly Rabenstein Donohoe
Owner
8432846389
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