| NPI | 1215463096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NINA BETH DILLENBECK Sole Mbr 443-398-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MD LC6977) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |