| NPI | 1699085993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY SUZANNE JORDAN Licensed Clinical Social Worker 410-446-5678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 12109) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2010-10-20 |