| NPI | 1699702654 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA H MATTHEWS Billing Representative 843-532-8549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2007-11-30 |