| NPI | 1083930721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFANIE MARIE CONSOLLA Clinical Psychologist 301-525-5141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04638) |
| Enumeration Date | 2010-04-19 |
| Last Update Date | 2015-05-06 |