| NPI | 1558828996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BIANCA FETHERSON Clinical Director/Co Owner 240-929-4387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-02-21 |
| Last Update Date | 2019-09-14 |