| NPI | 1902045024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA TYLER TODD Professional Counselor 843-446-0541 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |