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 |