| NPI | 1417789504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT GLOEFLER Office Manager 443-917-2886 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2024-08-16 |