| NPI | 1952517229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE J. ALEXANDER Owner 843-556-8177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: SC 22098) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 1981) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2019-09-25 |