| NPI | 1679782205 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIE BRYAN MOZINGO Managing Partner 803-779-3548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TP0016X Psychologist, Prescribing (Medical) |
| 104100000X Social Worker | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2020-08-22 |