| NPI | 1619441631 |
|---|---|
| Other Name | TALYA BRADFORD |
| Entity Type | Organization |
| Authorized Contact | TALYA BRADFORD Owner 443-871-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-12 |
| Last Update Date | 2024-06-30 |