| NPI | 1144947797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALI GAUVIN Co Owner 240-585-7128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Additional Taxonomies | 208000000X Pediatrics |
| 2080P0202X Pediatrics, Pediatric Cardiology | |
| 235Z00000X Speech-Language Pathologist, | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-11-01 |