| NPI | 1447436290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL M. GRANT President/Secretary 843-839-9028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: SC 1071) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2009-03-06 |