| NPI | 1821462557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | M RENEE MOTTENON-THOMPSON Owner/Operator 301-275-6737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 05186) |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |