| NPI | 1316346711 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE DONNELLY Owner 410-742-7160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 111175) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 103TC1900X Psychologist, Counseling (Licence: MD 03248) | |
| 1041C0700X Social Worker, Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-10-22 |