| NPI | 1184233595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE YOUVONNE KINGEL Nurse Practitioner 410-624-7190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |