| NPI | 1750133641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN F WAGNER Licensed Professional Counselor 803-240-5448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |