Individual
MISS SUZANNAH GLOVER COUNTRYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ED.S., LPES
Contact information
Practice address
7301 RIVERS AVE, SUITE 100, NORTH CHARLESTON, SC 29406-4650
(843) 343-1012
Mailing address
7301 RIVERS AVE, SUITE 100, NORTH CHARLESTON, SC 29406-4650
(843) 343-1012
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
4662
SC
103TS0200X
School Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588615918
—
SC
Enumeration date
10/02/2013
Last updated
04/14/2016
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