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1386214245
CRESCENT MOON PSYCHOTHERAPY, LLC
FORT MILL, SC
NPI
1386214245
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Entity Type
Organization
Authorized Contact
LUANNE IMHOLT
Sole Owner
313-509-7699
Organization Subpart ?
No
Primary Taxonomy
251S00000X
Enumeration Date
2021-07-01
Last Update Date
2021-07-01
Business Address
CRESCENT MOON PSYCHOTHERAPY, LLC
2021 BRIDGEMILL DR
FORT MILL, SC 29707-9210
Phone number: 313-509-7699
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Mailing Address
CRESCENT MOON PSYCHOTHERAPY, LLC
1249 ASHLEY CREEK DR
MATTHEWS, NC 28105-2442
Phone number: 803-422-3779
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