| NPI | 1942917604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KANISHA FORDHAM MILLER Owner/Counselor 843-709-3392 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-11-02 |
| Last Update Date | 2022-11-02 |