| NPI | 1699407338 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINA DOMINGUEZ CRAVEN Director 410-693-8966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2022-06-30 |
| Last Update Date | 2024-01-26 |