| NPI | 1790991941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE K STOCKWELL Counselor 843-406-0013 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 2229) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |