| NPI | 1306085683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN CLENDANIEL Billling Manager 410-810-2465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP2701X Psychologist, Group Psychotherapy |
| Enumeration Date | 2009-02-11 |
| Last Update Date | 2016-10-18 |