Individual
JANA ISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7301 RIVERS AVE, SUITE 100, NORTH CHARLESTON, SC 29406-4650
(843) 637-4211
Mailing address
7301 RIVERS AVE, SUITE 100, NORTH CHARLESTON, SC 29406-4650
(843) 637-4211
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
222790
SC
Other
Enumeration date
04/13/2017
Last updated
04/13/2017
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