| NPI | 1407194905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA EARLY Clinical D Irector 410-914-4012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC0793) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2023-03-14 |