Provider Demographics
NPI:1629728621
Name:ALLS, NAYNARIUM
Entity Type:Individual
Prefix:MISS
First Name:NAYNARIUM
Middle Name:
Last Name:ALLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 RAINBOW DR STE 208
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4155
Mailing Address - Country:US
Mailing Address - Phone:843-472-8299
Mailing Address - Fax:
Practice Address - Street 1:300 RAINBOW DR STE 208
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4155
Practice Address - Country:US
Practice Address - Phone:843-472-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician