| NPI | 1023357027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE DONNELLY Licensed Psychologist 410-742-7160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MD 03248) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical (Licence: MD 111175) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 08692) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2014-10-16 |