| NPI | 1548027329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA BURKS Owner 443-983-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-28 |
| Last Update Date | 2024-02-28 |