| NPI | 1528562477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAYLA R FORTENBERRY Owner / Therapist 864-494-5462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6611) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |