| NPI | 1538361746 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIFER A BENNICE Licensed Clinical Psychologist 843-330-8663  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: SC 985)  | 
| Enumeration Date | 2007-06-01 | 
| Last Update Date | 2020-08-22 |