| NPI | 1275900961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA KNOX-FRAZIER CEO 864-406-6041 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 27451) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 27451) |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC 27451) | |
| Enumeration Date | 2015-08-28 |
| Last Update Date | 2015-08-28 |