| NPI | 1730413634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO JOSE FERMO Medical Doctor/ Psychiatrist 843-478-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist Prescribing (Medical) (Licence: SC 18143) |
| Additional Taxonomies | 103TP0016X Psychologist Prescribing (Medical) (Licence: SC 25547) |
| 106H00000X Marriage & Family Therapist (Licence: SC 4478) | |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |