| NPI | 1346396439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELYNN C. LUCK Therpist 443-944-0401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 06132) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2007-11-01 |