| NPI | 1174246466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE CLAIRE RODERICK Clinical Psychologist 571-234-8106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2022-10-17 |