| NPI | 1104787217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA FAWN MITCHELL Therapist 240-498-9089 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-11-19 |
| Last Update Date | 2026-01-13 |