| NPI | 1821723677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY TAYLOR SPRAGUE Office Manager 843-267-8781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-07-17 |
| Last Update Date | 2022-07-28 |