| NPI | 1235973652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY PORTER Member 301-537-8846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-06-20 |
| Last Update Date | 2024-07-09 |