Roberts, Miranda Shawntay
Roberts, Miranda Shawntay is an individual health care provider with primary practice located at 1035 Cheraw Street , Bennettsville SC 29512. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Roberts, Miranda Shawntay can be contacted via phone (843) 544-4060.Contact Information
Primary practice address
1035 Cheraw Street
Bennettsville SC 29512
Phone: (843) 544-4060
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X |
Profile Details
| NPI number | 1356981542 |
|---|---|
| LBN Legal business name | Roberts, Miranda Shawntay |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 15th, 2020 |
| Last updated | Jan 15th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356981542 | NPPES |
| South Carolina | MEDICAID | 405127 |
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