| NPI | 1710374335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN PROVOST Clinical Counselor 864-354-0963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5796) |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |