| NPI | 1174397939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNTEL MONIQUE GLADNEY CEO 443-622-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2023-11-13 |