| NPI | 1003151291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENNADY VINOKUR Manager 301-330-0006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| 101YM0800X Counselor, Mental Health | |
| 2084N0400X Psychiatry & Neurology, Neurology | |
| 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry | |
| Enumeration Date | 2012-11-29 |
| Last Update Date | 2020-07-02 |