Provider Demographics
NPI:1831947316
Name:HOBSON, ELIZABETH MIRANDA (CPSS)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MIRANDA
Last Name:HOBSON
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:NORRIS
Mailing Address - State:SC
Mailing Address - Zip Code:29667-0187
Mailing Address - Country:US
Mailing Address - Phone:864-396-0977
Mailing Address - Fax:
Practice Address - Street 1:309 E MAIN ST
Practice Address - Street 2:1
Practice Address - City:PICKENS
Practice Address - State:SC
Practice Address - Zip Code:29671-2319
Practice Address - Country:US
Practice Address - Phone:864-898-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-09
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCPSS2092175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist