| NPI | 1073867214 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA GOTTLIEB Managing Member 301-502-6560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4324) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC4324) |
| 101YM0800X Counselor, Mental Health (Licence: MD LC4324) | |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2012-11-08 |