| NPI | 1528818820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT ANTHONY RENNA Provider/Owner 443-616-8483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-03-27 |
| Last Update Date | 2024-03-27 |