NPI | 1528448404 |
---|---|
Entity Type | Organization |
Authorized Contact | TIFFINIE CARROLL Executive Director 410-363-3713 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD 404629300) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD ATC110) |
101YP2500X Counselor, Professional (Licence: MD LC3003) | |
Enumeration Date | 2015-06-04 |
Last Update Date | 2015-11-19 |