| NPI | 1184003865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YVETTE MOULTON EADDY Therapist 443-500-0258 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6342) |
| Enumeration Date | 2015-05-27 |
| Last Update Date | 2015-05-27 |