| NPI | 1689207607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON JOSEPH PHILLIPS Owner 443-206-8326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2020-02-18 |
| Last Update Date | 2020-02-18 |