| NPI | 1003615238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRAM MALCOLM KERRY DIRTON Clinical Director 864-979-1325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2025-03-11 |
| Last Update Date | 2025-03-11 |