| NPI | 1497313282 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEAN GLEN OLIVER BAXTER Owner 202-751-6444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2019-06-05 |
| Last Update Date | 2019-06-05 |