| NPI | 1942611066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN JOHN PHILLIPS Director, Clinical Counselor 803-322-5242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5690) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5690) |
| Enumeration Date | 2014-05-12 |
| Last Update Date | 2014-05-12 |