| NPI | 1659929487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMELA JEAN FERGUSON Chief Executive Officer 443-802-5130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2021-02-01 |