| NPI | 1104274547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL JOHN LABELLARTE Principle 410-979-2326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 103T00000X Psychologist | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| Enumeration Date | 2016-05-26 |
| Last Update Date | 2016-05-26 |