| NPI | 1134639628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA BUTTACAVOLI-SMITH Owner 410-929-1719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2017-10-10 |