| Bianca Jardin Phd Llc | |
|
523 Live Oak Dr Mt Pleasant SC 29464-4365 | |
| (843) 300-2095 | |
| (843) 480-9579 |
| Full Name | Bianca Jardin Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 523 Live Oak Dr, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Bianca Jardin (PSYCHOLOGIST) |
| Authorized Official Contact | 8433002095 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bianca Jardin Phd Llc 523 Live Oak Dr Mt Pleasant SC 29464-4365 Ph: (843) 300-2095 | Bianca Jardin Phd Llc 523 Live Oak Dr Mt Pleasant SC 29464-4365 Ph: (843) 300-2095 |
| NPI Number | 1033653910 |
|---|---|
| Provider Enumeration Date | 12/12/2016 |
| Last Update Date | 02/12/2021 |
| Certification Date | 02/12/2021 |
| Medicare PECOS PAC ID | 6406131093 |
|---|---|
| Medicare Enrollment ID | O20170322001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033653910 | NPI | - | NPPES |
| PG0176 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 1285 (South Carolina) | Primary |
| Provider Name | Bianca F Jardin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285064956 PECOS PAC ID: 4486884566 Enrollment ID: I20140312000199 |
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