Individual
JILL CRYSTAL PAYNE ILAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1041 JOHNNIE DODDS BLVD, SUITE 5C, MT PLEASANT, SC 29464-6156
(843) 693-9650
Mailing address
1041 JOHNNIE DODDS BLVD, SUITE 5C, MT PLEASANT, SC 29464-6156
(843) 693-9650
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1067
SC
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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