Provider Demographics
NPI:1346875556
Name:INTREPID INTEGRATIVE SOLUTIONS, INC
Entity Type:Organization
Organization Name:INTREPID INTEGRATIVE SOLUTIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANSO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:803-947-9231
Mailing Address - Street 1:229 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-3579
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:229 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-3579
Practice Address - Country:US
Practice Address - Phone:803-947-9231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-09
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty