| NPI | 1134683006 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXIS SANDERS Licensed Clinical Psychologist 843-621-0263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103TF0200X Psychologist, Forensic |
| 103TH0004X Psychologist, Health | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2020-06-09 |