| NPI | 1417563958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONIQUE GILCREST Lpc 803-636-2713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2020-09-21 |