| NPI | 1871161190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA L. L. DESROSIERS Clinical Psychologist 443-617-5152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2021-06-14 |