| NPI | 1003930777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RALPH D RAPHAEL Psychologist 410-825-0042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 1705) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MD 1705) |
| 103TC1900X Psychologist, Counseling (Licence: MD 1705) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2020-08-22 |