| NPI | 1114291234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY LEE FORREST Psychotherapist Ii 240-620-1399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD 13240) |
| Enumeration Date | 2012-03-07 |
| Last Update Date | 2012-03-07 |