| NPI | 1295515765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY SHAW Pmhnp/Partner 843-321-5099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-10-03 |
| Last Update Date | 2023-10-03 |