| NPI | 1316819642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLOR STUART Provider/Owner 843-742-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-09-17 |
| Last Update Date | 2025-09-17 |