| NPI | 1932613932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA BLAKEMAN Owner 843-424-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05744600) |
| Enumeration Date | 2017-11-29 |
| Last Update Date | 2022-11-28 |