| NPI | 1154025799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA LEAMAN Practice Manager 843-492-7284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-03-28 |
| Last Update Date | 2023-03-28 |