| NPI | 1407126485 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER MOSKOS Credentialing Coordinator 410-569-9497 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: VA 0810004338) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |