| NPI | 1487145991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA K WOLZ Owner 410-657-2982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MD 19466) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2018-09-17 |