| NPI | 1245091917 |
|---|---|
| Doing Business As | SOUTHERN OM TELEPSYCHIATRIC SERVICES |
| Entity Type | Organization |
| Authorized Contact | JARED JOSHUA CARBONE Owner 864-477-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-03-04 |