| NPI | 1003187162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL R MYERS Therapist/Consultant 301-502-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD 08588) |
| Enumeration Date | 2012-01-21 |
| Last Update Date | 2012-01-21 |