| NPI | 1235996786 |
|---|---|
| Other Name | NURSE PRACTITIONER |
| Entity Type | Organization |
| Authorized Contact | BRITTANY RAQUEL JOHNSON Nurse Practitioner 443-797-2364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |