Individual
DR. PAUL EDWARD VANWYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1528 BLANDING ST, COLUMBIA, SC 29201-2907
(803) 252-9444
(803) 748-9220
Mailing address
1528 BLANDING ST, COLUMBIA, SC 29201-2907
(803) 252-9444
(803) 748-9220
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
195
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0044
—
SC
Enumeration date
04/18/2007
Last updated
07/08/2007
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