| NPI | 1104448448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TESSA SHEREE PERRY Director 443-943-6057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-05-09 |
| Last Update Date | 2020-05-09 |