| NPI | 1609480870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IFEOMA J DUNN Credentialing Specialist 443-453-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2020-09-03 |
| Last Update Date | 2021-01-07 |