| NPI | 1700575677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MUTINTA CHESTNUT Medical Director 443-557-8519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-12-04 |