| NPI | 1184489791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAVONDA KEATING Dir Provider Enrollment 410-302-2229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2024-02-14 |
| Last Update Date | 2024-02-14 |