| NPI | 1497212468 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINA MARIE DECOSTANZO-ALLEN Program Director 443-900-7118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |