Individual
DR. SUDIE E BACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
125 DOUGHTY STREET, SUITE 120, CHARLESTON, SC 29425
(843) 792-5215
(843) 792-0528
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1024
SC
Other
Enumeration date
05/25/2006
Last updated
10/29/2020
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