| NPI | 1437907912 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JESSICA ANN VICKERS Owner & Therapist 443-203-9850  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| Enumeration Date | 2024-05-09 | 
| Last Update Date | 2025-05-06 |