| NPI | 1740965995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRIA R. WATSON Owner 843-865-0109 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 103T00000X Psychologist |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2023-06-15 |
| Last Update Date | 2023-06-21 |