| NPI | 1811619380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINNY HAYDEN Licensing Manager 240-728-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-09-13 |
| Last Update Date | 2022-09-13 |