| NPI | 1659752467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCELLUS RYAN CEPHAS Medical Director 301-891-2077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: MD D0059532) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC3762) |
| 1041C0700X Social Worker, Clinical (Licence: MD 17917) | |
| 1041C0700X Social Worker, Clinical (Licence: MD 13814) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2015-06-17 |