| NPI | 1053141325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE RAE GILLIS President 443-420-8391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-08-02 |