| NPI | 1356959589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | XANDER FAISON Clinician 443-876-0637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0000X Psychologist, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251B00000X Case Management | |
| 251S00000X | |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2021-07-05 |