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 |