NPI | 1265920615 |
---|---|
Entity Type | Organization |
Authorized Contact | TAMALA BUTLER Credentialing Specialist 301-883-7822 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QS1000X Clinic/Center, Student Health |
Additional Taxonomies | 261QP0905X Clinic/Center, Public Health, State or Local |
Enumeration Date | 2018-05-01 |
Last Update Date | 2020-09-17 |