| NPI | 1770782799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENA K MCKEOWN Psycho Educational Specialist 803-254-9767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: SC 4563) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |