| NPI | 1275056616 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CANNON PHELPS Owner/Psychiatrist 843-870-2779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL OS12896) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2019-09-03 |