| NPI | 1326633595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHALL MIDDLE NAME JAMES CEO 443-519-6409 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2021-03-09 |
| Last Update Date | 2023-11-14 |