| NPI | 1861607574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRISON MANGUM KISNER Owner 864-360-4341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 006453) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2009-07-27 |