| NPI | 1154872059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHARLES EDMUNDS Human Resource 410-372-7628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2021-05-05 |