| NPI | 1134525710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN MCCOY Clinical Director 410-766-6624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC3585) |
| Enumeration Date | 2014-11-10 |
| Last Update Date | 2017-01-18 |