| NPI | 1477136877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISHA-LEIGH PORTER Owner / Np 443-379-4410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2021-07-02 |