| NPI | 1265207310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE POPE Psychiatric Nurse Practitioner 443-851-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2024-01-21 |