| NPI | 1134749633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE MOFFATT Organizer 803-448-1590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 102L00000X Psychoanalyst | |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2020-04-24 |