Organization
ALEXANDR MICHAEL FEDERER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDR MICHAEL FEDERER PH.D. (LICENSED CLINICAL PSYCHOLOGIST)
(843) 673-0727
Entity
Organization
Contact information
Practice address
323 S MCQUEEN ST, FLORENCE, SC 29501-4722
(843) 673-0727
(843) 667-1549
Mailing address
323 S MCQUEEN ST, FLORENCE, SC 29501-4722
(843) 673-0727
(843) 667-1549
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
569
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0173
—
SC
Enumeration date
02/09/2007
Last updated
08/22/2020
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