| NPI | 1124596606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIA D ROLLINS-MUSGRAVE Owner 443-534-3652 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health |
| 207Q00000X Family Medicine | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2020-08-05 |