| NPI | 1548045859 |
|---|---|
| Doing Business As | EVERGREEN THERAPY |
| Entity Type | Organization |
| Authorized Contact | AMY LOUISE GIBBS BENNETT Clinical Mental Health Therapist 443-808-1083 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-28 |