Organization
HYPNOSIS PLUS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOREL HUMBURG LISW-CP, CH (PSYCHOTHERAPIST)
(803) 707-8397
Entity
Organization
Contact information
Practice address
2323 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-2042
(803) 707-8397
Mailing address
2525 FAIRWAY DR, ORANGEBURG, SC 29118-4005
(803) 707-8397
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
SC6583
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164457719
INDIVIDUAL
SC
Enumeration date
03/09/2010
Last updated
04/20/2010
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