| NPI | 1083285928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD EUGENE SHEPPARD Co Owner 443-584-6773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2023-01-11 |