| NPI | 1073053104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY NAGEL Owner/Clinician 301-518-6870 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LC6296) |
| Enumeration Date | 2017-03-08 |
| Last Update Date | 2017-03-08 |