| NPI | 1174342547 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA FETHERSON Owner 443-484-8336 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-11-24 |