Faucette, Mary Rutledge

Faucette, Mary Rutledge is an individual health care provider with primary practice located at 117 E Main St , Moncks Corner SC 29461-3764. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Faucette, Mary Rutledge can be contacted via phone (843) 899-4949.

Contact Information

Primary practice address
117 E Main St Moncks Corner SC 29461-3764
Phone: (843) 899-4949
Fax: (843) 899-7224
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 811 South Carolina

Profile Details

NPI number 1245332329
LBN Legal business name Faucette, Mary Rutledge
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 1st, 2006
Last updated Sep 10th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245332329 NPPES
South Carolina MEDICAID PSO353

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