| NPI | 1124298484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD MABRY CEO 301-818-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: DC 1652) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: DC 103000A-DT-Y-068) |
| 1041C0700X Social Worker, Clinical (Licence: DC LC301420) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2023-03-22 |