Individual
JAY E EARLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
120 CHESTERFIELD ST N, AIKEN, SC 29801-3934
(803) 641-9979
Mailing address
179 BLAIR DR, NORTH AUGUSTA, SC 29860-9785
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
773
AL
103TH0004X
Health Psychologist
Primary
1469
SC
Other
Enumeration date
01/10/2007
Last updated
03/17/2018
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