| NPI | 1649656943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUERITE PETRANELLA LABAN Owner 410-371-7187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05420) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2023-08-08 |