| NPI | 1467009423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRIDONNA DEVAL BRANDFORD Owner 443-898-6622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-08-23 |
| Last Update Date | 2025-12-17 |