| NPI | 1225557440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY D RAVENEL Licensed Professional Counselor 843-709-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SC 6482) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2017-09-19 |