| Clemson Behavioral Health Pa | |
|
398 College Ave Clemson SC 29631-1432 | |
| (864) 653-4112 | |
| (864) 653-4129 |
| Full Name | Clemson Behavioral Health Pa |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 398 College Ave, Clemson, South Carolina |
| Authorized Official Name and Position | Jacqueline D Mouzon (PSYCHIATRIST) |
| Authorized Official Contact | 8646534112 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clemson Behavioral Health Pa 398 College Ave Clemson SC 29631-1432 Ph: (864) 653-4112 | Clemson Behavioral Health Pa 398 College Ave Clemson SC 29631-1432 Ph: (864) 653-4112 |
| NPI Number | 1467575936 |
|---|---|
| Provider Enumeration Date | 04/09/2007 |
| Last Update Date | 01/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467575936 | NPI | - | NPPES |
| GP3804 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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