| NPI | 1225532476 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA DENISE HOTT Owner 803-310-5994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: SC 20663) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: SC 20663) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2023-12-20 |