| NPI | 1215541669 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CERRISSA MICHELLE HUGIE Owner/Provider 803-351-8252 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health | 
| Additional Taxonomies | 251S00000X Community/Behavioral Health | 
| Enumeration Date | 2020-09-03 | 
| Last Update Date | 2024-10-28 |