Provider Demographics
NPI:1952538134
Name:HINTON, LARENE HARRIS
Entity Type:Individual
Prefix:
First Name:LARENE
Middle Name:HARRIS
Last Name:HINTON
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 1:1105 SEASIDE LN
Mailing Address - Street 2:APT1
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-5300
Mailing Address - Country:US
Mailing Address - Phone:843-406-9407
Mailing Address - Fax:
Practice Address - Street 1:1105 SEASIDE LN
Practice Address - Street 2:APT1
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-5300
Practice Address - Country:US
Practice Address - Phone:843-406-9407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-16
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCDL#007992433347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle