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Individual

ANDREA T EATON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
735 MCMILLAN RD, CLEMSON, SC 29634-0001
(864) 656-2451
Mailing address
BOX 344054, CLEMSON, SC 29634-0001
(864) 656-2451

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1631
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1760596480
SC
Enumeration date
01/12/2012
Last updated
09/04/2025
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