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Organization
KIDS COUNSELING AND AUTISM THERAPEUTIC CENTER COMPANY
Active
Organization
KIDS COUNSELING AND AUTISM THERAPEUTIC CENTER COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NICOLE L HAUNROTH LPC (CEO AND PRESIDENT)
(843) 995-9025
Entity
Organization
Contact information
Practice address
5049 OAT FIELDS DR, MYRTLE BEACH, SC 29588-3720
(708) 289-6911
Mailing address
5049 OAT FIELDS DR, MYRTLE BEACH, SC 29588-3720
(708) 289-6911
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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