| NPI | 1730784398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDIDIAMAKA EZINNE MBAKPUO Managing Director 301-712-4637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 251S00000X |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2020-12-02 |
| Last Update Date | 2023-08-17 |