| NPI | 1396280020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER K POTTS Psychotherapist 443-523-0559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MD LC7436) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2017-01-04 |