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Organization

CANNON PSYCHOLOGICAL ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ELIZABETH TRACY GOODE (OFFICE MANAGER)
(864) 654-7848
Entity
Organization

Contact information

Practice address
1376 TIGER BLVD STE 210, CLEMSON, SC 29631-2654
(864) 654-7848
(864) 654-5777
Mailing address
1376 TIGER BLVD STE 210, CLEMSON, SC 29631-2654
(864) 654-7848
(864) 654-5777

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
349
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PS0078
SC
Enumeration date
10/25/2006
Last updated
09/06/2023
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