| NPI | 1528705530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN K Practice Manager 443-367-1333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-05-19 |
| Last Update Date | 2022-11-22 |