| NPI | 1518396100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH ANN UPSHAW Clinical Supervisor 301-576-0131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA393) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |