| NPI | 1003004508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL M RUSSELL Professional Counselor 803-261-1621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4739) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2007-10-09 |