| NPI | 1275012312 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINTON JARED LEWIN Owner 410-703-6784 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05951) |
| Enumeration Date | 2018-08-09 |
| Last Update Date | 2022-12-13 |