| NPI | 1528428851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY DECHELLE WIGGINS Owner/ Office Manager 803-741-5840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2021-10-25 |