| NPI | 1710357447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIA DEVINE Therapist 240-298-6680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 05590) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC5662) |
| 251S00000X Community/Behavioral Health (Licence: MD LC5662) | |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |