| NPI | 1316187222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA CHARLENE REVELS Counselor 803-329-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4263) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2009-03-05 |