| NPI | 1114345352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILHELMENA VICTORIA VANDENBURG Licensed Clinical Social Worker 410-790-4833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 10361) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |