| NPI | 1598140063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE RENE WATSON Managing Member 240-488-4131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2015-07-27 |
| Last Update Date | 2016-01-11 |