| NPI | 1609163450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW WALEN Owner, Executive Director 443-602-6515 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 15245) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC3911) |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2011-06-30 |