NPI | 1548933302 |
---|---|
Entity Type | Organization |
Authorized Contact | SUSSAN ONONAKU Provider 240-423-2043 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
Enumeration Date | 2021-07-28 |
Last Update Date | 2021-07-28 |