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KRISTINA KANIA BATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
200 PATEWOOD DR STE A200, GREENVILLE, SC 29615-3580
(864) 454-5115
(864) 454-5111
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1407
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PS0611
SC
Enumeration date
01/09/2014
Last updated
05/27/2021
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