| NPI | 1477366722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK ANTHONY RONCONE Owner Provider 240-203-8864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-01-30 |
| Last Update Date | 2025-01-30 |