| NPI | 1063061620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON SMITH Practice Manager 803-590-8623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2019-09-06 |
| Last Update Date | 2025-07-16 |