| NPI | 1629083357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SABRINA ANN MACKALL Credentialing Sepcialist 410-266-8345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC0700X Psychologist Clinical | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2013-09-05 |