| NPI | 1750717286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTE DIANE LEVESQUE-NIEMAN Clinical Director 410-455-0098 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 12165) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC4640) |
| Enumeration Date | 2013-09-16 |
| Last Update Date | 2013-09-16 |