| NPI | 1225229792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANAE ALLYSON WHEATLEY Clinical Director/Therapist 410-494-9440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MD 10748) |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2008-01-03 |