| NPI | 1104061258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ANGELLA PAYNE Clinical Director 301-627-6816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD RN117769) |
| Enumeration Date | 2008-12-03 |
| Last Update Date | 2008-12-03 |