| NPI | 1396242152 |
|---|---|
| Doing Business As | MENTAL HEALTH PROVIDER |
| Entity Type | Organization |
| Authorized Contact | ALDIN GORDON Mental Health Provider 410-475-0338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-06-16 |