| NPI | 1760838569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE M BAIN Executive /Clinical Director 410-719-0086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC6983) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2016-05-11 |