| NPI | 1407274657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE FONROSE Clinical Director 301-474-0060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103TC1900X Psychologist Counseling | |
| 103TP2701X Psychologist Group Psychotherapy | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2014-04-04 |