| NPI | 1912338294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN E WILLIAMS Lpc 843-834-6037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: SC 5327) |
| Additional Taxonomies | 251S00000X (Licence: SC 12033037) |
| Enumeration Date | 2013-12-11 |
| Last Update Date | 2013-12-11 |