| NPI | 1134657893 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE A OSENTOSKI Licensed Psychologist 843-422-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 1215) |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2018-02-16 |