| NPI | 1003638578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGIE OLLER BURR Director Of Professional Fees 410-706-5181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2024-10-28 |
| Last Update Date | 2025-01-24 |