| NPI | 1629633870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RABENSTEIN DONOHOE Owner 843-284-6389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-06-11 |