| NPI | 1063924637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON SENEFELD Owner 443-698-8326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05015) |
| Additional Taxonomies | 103TA0700X Psychologist, Adult Development & Aging (Licence: MD 05015) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 05015) | |
| 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 05015) | |
| 103TH0004X Psychologist, Health (Licence: MD 05015) | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities (Licence: MD 05015) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2017-11-03 |