Individual
JESSICA KANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2913 SPLIT HICKORY CT, JOHNS ISLAND, SC 29455-8303
(843) 608-1252
Mailing address
PO BOX 415, JOHNS ISLAND, SC 29457-0415
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1784
SC
103TC0700X
Clinical Psychologist
1784
SC
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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