| NPI | 1184216251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KORLU WOLOBAH-KUYON Provider 301-803-9617 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2021-02-09 |
| Last Update Date | 2021-02-09 |