| NPI | 1205282449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LOUISE SMITH Clinical Supervisor 443-655-7164 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC1174) |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-27 |