| NPI | 1215528369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETSY MOORE Owner 443-750-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2024-06-05 |