| NPI | 1093575722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS ANGEL LAGTAPON GUEVARA Child And Adolescent Psychiatrist 843-256-3326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |