| NPI | 1871257964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINNY HAYDEN Licensing Manager 240-728-5864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-10-26 |
| Last Update Date | 2024-07-31 |