| NPI | 1689812216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JOSEPH PORTNEY Therapist 803-442-9410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 4379) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 2590) |
| Enumeration Date | 2009-02-04 |
| Last Update Date | 2009-02-04 |