| NPI | 1306068440 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY LOUIS MOSS Licensed Clinical Social Worker 410-995-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MD 00970) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2011-10-11 |