| NPI | 1730744434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEROY MILLER Office Manager 301-977-0824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |