Organization
SOUTH CAROLINA INTERVENTIONISTS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBORAH ANN WARDELL MED,, BCBA (OWNER)
(843) 424-1129
Entity
Organization
Contact information
Practice address
1860 AUBURN LN, APARTMENT 19C, MYRTLE BEACH, SC 29575-5159
(843) 424-1129
Mailing address
1860 AUBURN LN, APARTMENT 19C, MYRTLE BEACH, SC 29575-5159
(843) 424-1129
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1073705
SC
Other
Enumeration date
12/28/2011
Last updated
12/28/2011
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