| NPI | 1699128835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN PAUL CHASTEEN Owner 843-817-9008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 6926) |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2016-07-22 |