Provider Information for 1407601289
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Mrs. JANE DAVIS PREVOST LPC
Sex: Female
NPI: 1407601289
Last Updated: 2024-04-23
Certification Date: 2024-04-23
Certification Date: 2024-04-23
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1407601289 | ||||||||
| Enumeration Date | 2024-04-23 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1135 KINCANNON DR MOUNT PLEASANT, SC 29464-3864 United States Phone: 828-329-1631 | Fax: | ||||||||
| Primary Practice Address | 1135 KINCANNON DR MOUNT PLEASANT, SC 29464-3864 United States Phone: 828-329-1631 | Fax: | ||||||||
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