Organization
CENTER FOR POSITIVE CHANGE, LLC
Active
Other names
HILTON HEAD HYPNOTHERAPY, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALIST)
(912) 484-3879
Entity
Organization
Contact information
Practice address
38 SHERIDAN PARK CIR, C/O CANNONFIT TRANSFORMATION, BLUFFTON, SC 29910-7022
(843) 368-6331
Mailing address
2 DOUBLE EAGLE DR, BLUFFTON, SC 29910-4950
(843) 368-6331
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5484
LICENSED PROFESSIONAL COUNSELOR INTERM
SC
Enumeration date
04/07/2015
Last updated
04/07/2015
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