| NPI | 1730898065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDACE SMITH-TUCKER Manager 240-353-4078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 103TC1900X Psychologist Counseling | |
| Enumeration Date | 2022-11-15 |
| Last Update Date | 2023-03-01 |