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Individual

JANIELLY SPAGOLA DIAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
75 CALHOUN ST, CHARLESTON, SC 29401-3538
(843) 402-7818
Mailing address
75 CALHOUN ST, CHARLESTON, SC 29401-3538
(843) 402-7818

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
269015
SC
104100000X
Social Worker

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588615918
SC
Enumeration date
03/01/2010
Last updated
09/09/2014
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