Individual
ANITA DEARING MCQUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
100 AUGUSTA ST, GREENVILLE, SC 29601-3504
(864) 455-2600
(864) 455-2621
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
729
SC
103G00000X
Clinical Neuropsychologist
SC729
SC
103T00000X
Psychologist
729
SC
103TA0700X
Adult Development & Aging Psychologist
729
SC
103TB0200X
Cognitive & Behavioral Psychologist
729
SC
103TC0700X
Clinical Psychologist
729
SC
103TH0100X
Health Service Psychologist
729
SC
103TR0400X
Rehabilitation Psychologist
729
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0283
—
SC
Enumeration date
01/18/2007
Last updated
05/11/2021
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