| NPI | 1396457800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENISE SEABROOK Nurse Practitioner 843-452-9746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2022-12-16 |