| NPI | 1437501806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L CORBETT Owner 803-883-4981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5859) |
| Enumeration Date | 2016-07-08 |
| Last Update Date | 2024-02-26 |