| NPI | 1659144657 |
|---|---|
| Other Name | --NONE-- |
| Entity Type | Organization |
| Authorized Contact | KEVIN DALE CLEGG Owner/Therapist 843-685-0696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2023-11-01 |
| Last Update Date | 2023-11-01 |