| NPI | 1033691407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER W WILSON Owner 410-868-0001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 18028) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA2105) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2018-09-03 |
| Last Update Date | 2023-03-03 |