| NPI | 1417283524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDNA NICOLE COGDELL-QUICK Owner 843-687-4183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4711) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 0603302) | |
| Enumeration Date | 2009-10-23 |
| Last Update Date | 2009-12-08 |