| NPI | 1104871946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R LANNON Executive Director 301-791-3045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2024-11-20 |