| NPI | 1154775682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MCLAURIN Managing Owner 443-617-7175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC6685) |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2018-01-25 |