| NPI | 1487418513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEEANN MARIE RANDOW Owner 443-671-4509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-02-08 |
| Last Update Date | 2024-02-08 |