| NPI | 1245046242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMA JUNE TAVERAS Nurse Practitioner 864-933-4097 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-12-05 |
| Last Update Date | 2024-12-11 |