| NPI | 1316493000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONETTA ALETHIA DAVIS Owner 410-357-6735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MD R149811) |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-08-31 |