| NPI | 1730384371 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PATRICIA SUZANNE SMITH Nurse Practioner 843-357-8558 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 29671) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 26971) | 
| Enumeration Date | 2007-06-15 | 
| Last Update Date | 2008-09-05 |