| NPI | 1356977268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES MAURICE HENRY Owner 240-300-4994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC1900X Psychologist Counseling | |
| 103TE1100X Psychologist Exercise & Sports | |
| 103TF0000X Psychologist Family | |
| 133NN1002X Nutritionist Nutrition, Education | |
| 133VN1201X Dietitian, Registered Nutrition, Obesity and Weight Management | |
| 251K00000X Public Health or Welfare | |
| 251S00000X Community/Behavioral Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2020-03-23 |