| NPI | 1346059615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODSHENNA GANZY Partner/Lpcs 803-361-6263 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2025-01-02 |
| Last Update Date | 2025-01-02 |