| NPI | 1205340031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE INGE Psychologist 202-406-0568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: MD 04797) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: MD 04797) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2017-12-01 |