| NPI | 1720414493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA NYANJOM Office Manager 410-740-3635 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2013-09-25 |