| NPI | 1801633813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LW LUCRETIA WILSON Pmhnp Bc 843-276-7384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-09 |