| NPI | 1417736091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PETRIK CEO 443-567-6091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2025-02-13 |