| NPI | 1487105896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH EVANS Director Of Compliance 410-219-9000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 1041C0700X Social Worker Clinical | |
| 207RA0401X Internal Medicine Addiction Medicine | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2022-08-23 |