| NPI | 1558499426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH W WELLS Owner 864-585-2214 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 2064) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: SC 1304) |
| 2084P0800X Psychiatry & Neurology Psychiatry (Licence: SC 06871) | |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |