| NPI | 1053748707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATAYA ROBINSON Office Manager 843-253-5034 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist Family Health (Licence: SC 17625) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: SC 5514) |
| 364SF0001X Clinical Nurse Specialist Family Health (Licence: SC 17462) | |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2014-04-10 |