| NPI | 1306705538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYANN CHARISSE LEE Clinic Lead 843-676-5650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-01-22 |
| Last Update Date | 2026-01-22 |