| NPI | 1679529226 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENEEN THERESA WYSOCKI Director 410-303-2641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 06753) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2020-08-22 |