| NPI | 1003852286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON F. BROY Clinical Director 410-467-0507 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC0380) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 09114) |
| 1041C0700X Social Worker, Clinical (Licence: MD 04058) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-08-22 |