| NPI | 1477066140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW KADRICH President 843-450-8611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |