Organization
JLS PHD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACLYN SOUSA (CLINICAL PSYCHOLOGIST)
(203) 518-1667
Entity
Organization
Contact information
Practice address
308 BERMUDA TOWNE ROW, MOUNT PLEASANT, SC 29464-8230
(203) 518-1667
Mailing address
308 BERMUDA TOWNE ROW, MOUNT PLEASANT, SC 29464-8230
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
01/19/2021
Last updated
10/22/2021
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