| NPI | 1598070682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M GRESHAM WILSON Dir Adm 443-528-5908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 04078) |
| Enumeration Date | 2010-08-12 |
| Last Update Date | 2010-08-12 |