Doctor Name: | MR. TIMOTHY WILLIAM LOEBS |
NPI Number: | 1114977394 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 2006 |
Business Practice Address: | 1945 Glenns Bay Rd Surfside Beach, SC - 295754833 |
Business Phone Number: | 8436508940 |
Business Fax Number: | 8436515398 |
Mailing Address: | Po Box 14452, SURFSIDE BEACH |
State: | SC |
Postal Code: | 295874452 |
Phone Number: | 8436508940 |
Fax Number: | 8436515398 |
NPI Enumeration Date: | 05/11/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 2006 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |