| NPI | 1205443066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELITA THAIS PSYCHOLOGICAL Clinical Psychologist 803-467-9628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |