| NPI | 1700242260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN VERSPRIL Billing Mgr 843-216-7640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: SC MD32844) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2026-02-05 |