| NPI | 1588376388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRTIS AGEN-DAVIS Owner/Nurse Practitioner 410-775-6394 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-12-23 |
| Last Update Date | 2025-07-24 |