| NPI | 1912621251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIONA PRAYLOW Owner 803-394-1308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-09-29 |