| NPI | 1467973081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA HARRIS Secretary 410-908-0063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD lc7958) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC7958) |
| Enumeration Date | 2017-07-05 |
| Last Update Date | 2022-07-21 |