| NPI | 1588107296 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA S CHRISTENSEN Owner 410-670-5889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD W17534231) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2025-06-05 |