| NPI | 1518637206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMNA WAQAR Practice Manager 571-435-3334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TP2701X Psychologist Group Psychotherapy | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |