| NPI | 1447948278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRYSTLE D BROWN Billing Manager 410-800-6251 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2023-08-17 |