| NPI | 1588987218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOREL HUMBURG Psychotherapist 803-707-8397 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: SC SC6583) |
| Enumeration Date | 2010-03-09 |
| Last Update Date | 2010-04-20 |