Individual
LYDIA HAREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2900 EVATT LN, SUITE 106, CHARLESTON, SC 29405-8700
(843) 745-5153
Mailing address
2900 EVATT LN, SUITE 106, CHARLESTON, SC 29405-8700
(843) 745-5153
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
20542
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205423
—
SC
Enumeration date
09/05/2006
Last updated
07/08/2007
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