| NPI | 1457864290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA GORDON Clinical Social Worker 240-473-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD 18124) |
| Additional Taxonomies | 251S00000X (Licence: DC LC50078379) |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |