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Individual

DR. AVIE JAMES RAINWATER III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
549 W EVANS ST, FLORENCE, SC 29501-3487
(843) 667-4949
(843) 667-3349
Mailing address
549 W EVANS ST, PO BOX 4131, FLORENCE, SC 29502-4131
(843) 667-4949
(843) 667-3349

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
489
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
248101096
TRICARE
SC
01
285004
MHN
SC
01
P00199753
METRAHEALTH
SC
05
PS0002
SC
01
PVPB174618
APS
SC
Enumeration date
11/21/2005
Last updated
06/05/2015
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