| NPI | 1639709322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA ROSENTHAL Office Manager 410-583-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC0700X Psychologist Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |