| NPI | 1629438122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA KEITA DENEEN CARTER Owner 410-864-0211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 04993) |
| Additional Taxonomies | 103TF0000X Psychologist, Family (Licence: MD 04993) |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: MD 04993) | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: MD 04493) | |
| 103TA0700X Psychologist, Adult Development & Aging (Licence: MD 04993) | |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: MD 04993) | |
| 103TC1900X Psychologist, Counseling (Licence: MD 04993) | |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2020-03-11 |