| Crescent Child Development Services | |
|
966 Governors Ct Mount Pleasant SC 29464-9257 | |
| (843) 813-1538 | |
| (888) 813-3318 |
| Full Name | Crescent Child Development Services |
|---|---|
| Speciality | Behavior Analyst |
| Location | 966 Governors Ct, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Tara Marie Gregori (DIRECTOR) |
| Authorized Official Contact | 8438131538 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crescent Child Development Services 966 Governors Ct Mount Pleasant SC 29464-9257 Ph: (843) 813-1538 | Crescent Child Development Services 966 Governors Ct Mount Pleasant SC 29464-9257 Ph: (843) 813-1538 |
| NPI Number | 1356621817 |
|---|---|
| Provider Enumeration Date | 08/27/2011 |
| Last Update Date | 04/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356621817 | NPI | - | NPPES |
| EN1160 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103K00000X | Behavior Analyst | (* (Not Available)) | Primary |
| 235Z00000X | Speech-language Pathologist | 2212 (South Carolina) | Secondary |
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