| NPI | 1619161718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCIA LYNN CLENDANIEL Billing Manager 410-810-2465 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2016-10-18 |