| NPI | 1750870804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA S CHRISTENSEN Clinical Director/Co Owner 443-869-6086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225C00000X Rehabilitation Counselor |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2019-02-20 |