| NPI | 1245366210 |
|---|---|
| Doing Business As | LEAP |
| Entity Type | Organization |
| Authorized Contact | KATHLEEN G. BROUGHAN President 843-723-0659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: SC 501) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: SC 437) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |