| NPI | 1316206170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA SMITH Practice Manager 410-992-3796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MD LC4180) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |