| NPI | 1033673496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYSON KETT Co Owner 410-684-3806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2023-05-05 |