Individual
JEROME PREZZY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MASTER'S OF ARTS
Contact information
Practice address
2611 FOREST DR, SUITE 114A, COLUMBIA, SC 29204-2379
(803) 799-0144
(803) 799-1136
Mailing address
2611 FOREST DR, SUITE 114A, COLUMBIA, SC 29204-2379
(803) 799-0144
(803) 799-1136
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
MRW054
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP9902
—
SC
Enumeration date
01/30/2007
Last updated
07/08/2007
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