NPI | 1821479635 |
---|---|
Entity Type | Organization |
Authorized Contact | MARCELLUS RYAN CEPHAS Medical Director, Owner 301-891-2077 |
Organization Subpart ? | Yes |
Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: MD D0059532) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC3762) |
103TP0016X Psychologist, Prescribing (Medical) (Licence: MD R193679) | |
1041C0700X Social Worker, Clinical (Licence: MD 13814) | |
Enumeration Date | 2015-06-17 |
Last Update Date | 2024-07-31 |