Basic Information
Provider Information
NPI: 1508391798
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANDREWS
FirstName: CARRIE
MiddleName:  
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Mailing Information
Address1: 300 E MCBEE AVE FL 4
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296012842
CountryCode: US
TelephoneNumber: 8645228603
FaxNumber:  
Practice Location
Address1: 109 PHYSICIANS DR STE B
Address2:  
City: GREER
State: SC
PostalCode: 296502446
CountryCode: US
TelephoneNumber: 8647979170
FaxNumber: 8647979175
Other Information
ProviderEnumerationDate: 04/25/2017
LastUpdateDate: 07/18/2022
NPIDeactivationReasonCode:  
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NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
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AuthorizedOfficialCredential:  
NPICertificationDate: 07/18/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0804X88422SCY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry

No ID Information.


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