| NPI | 1477813822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN T LEWIS Professional Counselor 443-632-8814 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD LC4446) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: MD LC4446) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2015-01-26 |