| NPI | 1235412685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN MICHAEL BERGERON Social Worker 843-318-6619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 8649) |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2011-09-22 |