| NPI | 1831708296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA MINNIETTE HEYWARD Clinic Administrator 803-792-9003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-07-30 |
| Last Update Date | 2023-04-25 |