| NPI | 1093128449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH R PHILLIPS Sole Proprietor 864-270-9150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: SC 1634) |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2014-06-03 |