| NPI | 1558893586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAEJON LYNNE MAKONNEN Owner 410-422-3386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD lc7426) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |