| NPI | 1336809847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECCA D HENRY Business Owner 410-382-2509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-12-23 |
| Last Update Date | 2026-01-09 |