| NPI | 1790665164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUANITA PARKER Nurse Practitioner 803-466-2414 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2025-09-05 |
| Last Update Date | 2025-09-05 |