Individual
MR. GREGORY LEE FEEBACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., ED.S.
Contact information
Practice address
403 DOVER CT, LEXINGTON, SC 29072-6750
(803) 758-1408
Mailing address
403 DOVER CT, LEXINGTON, SC 29072-6750
(803) 309-4763
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
212678
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
WP8969
—
SC
Enumeration date
05/13/2006
Last updated
01/03/2013
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