| NPI | 1265573729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERYL R JACOBS Director 410-580-9045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 2899) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: MD 2899) |
| 103T00000X Psychologist (Licence: MD 2899) | |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2020-08-22 |