| NPI | 1083311138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS GUTHUA Psychologist 410-803-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2025-01-15 |