| NPI | 1104147073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE RENEE EVANS Licensed Professional Counselor 864-266-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 5012) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |