| NPI | 1053879007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMANTHA BRENNER GAUTIER Owner, Lpc 803-939-6747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2022-04-27 |