| NPI | 1174073290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMILY WILSON Clinical Psychologist 443-281-3675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MD 05790) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |