| NPI | 1851575252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYN INMAN Billing Agent 843-377-1600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: SC 22504) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 22504) |
| 101YP2500X Counselor, Professional (Licence: SC 22504) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: SC 22504) | |
| 106H00000X Marriage & Family Therapist (Licence: SC 22504) | |
| Enumeration Date | 2007-12-20 |
| Last Update Date | 2008-03-05 |