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 |