| NPI | 1700467222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA HAYES Credentialing Specialist 443-345-1317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2021-04-16 |
| Last Update Date | 2021-08-09 |