| NPI | 1275578502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON BROY Clinical Director 410-466-1345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA043) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LCO380) |
| 1041C0700X Social Worker, Clinical (Licence: MD 09114) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 04058) | |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2020-08-22 |