| NPI | 1689067886 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DR JESSICA PENA Therapist 803-406-5442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC PC1420) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2023-12-16 |