Organization
MULTIDISCIPLINARY THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TORI SULLIVAN LEATHERS (PRESIDENT/CEO)
(803) 410-5483
Entity
Organization
Contact information
Practice address
1634 TAYLOR ST, COLUMBIA, SC 29201-3451
(803) 410-5483
Mailing address
1634 TAYLOR ST, COLUMBIA, SC 29201-3451
(803) 410-5483
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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