| NPI | 1568906394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA WILSON President 843-834-2656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: SC 11521189) |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2017-11-13 |