| NPI | 1619019825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY KING President 803-252-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC SC 217) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |