| NPI | 1104222827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERNEST ROLL Owner 410-301-4663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC2668) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2014-11-06 |
| Last Update Date | 2021-12-16 |