| 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 | 2020-09-03 |