| NPI | 1114420957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL BRUCE MINTEER Owner 443-775-0126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 20221) |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2018-03-16 |