Organization
BIANCA JARDIN PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BIANCA JARDIN PHD (AUTHORIZED OFFICIAL)
(812) 401-0941
Entity
Organization
Contact information
Practice address
1050 JOHNNIE DODDS BLVD, #2381, MT PLEASANT, SC 29465-2801
(812) 401-0941
(843) 480-9579
Mailing address
1050 JOHNNIE DODDS BLVD, # 2381, MT PLEASANT, SC 29465-2381
(812) 401-0941
(843) 480-9579
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1285
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PG0176
—
SC
Enumeration date
12/12/2016
Last updated
08/01/2024
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