Provider Demographics
NPI:1659774636
Name:MCCLOY, SANDRA G (PHD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:G
Last Name:MCCLOY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 CYPRESS SPRINGS CT
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036-9168
Mailing Address - Country:US
Mailing Address - Phone:803-699-8887
Mailing Address - Fax:803-699-8824
Practice Address - Street 1:115 ATRIUM WAY
Practice Address - Street 2:SUITE 221
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29223-6371
Practice Address - Country:US
Practice Address - Phone:803-699-8887
Practice Address - Fax:803-699-8824
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1330103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist