| NPI | 1609314293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA ELAINE QUAST Lpc 843-945-0346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 251S00000X (Licence: SC 6522) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2019-10-25 |