| NPI | 1346810678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN GORMAN Dr. 410-807-5312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2021-06-29 |