| NPI | 1871962548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA DOCKERY Billing Manager 301-747-4364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2021-01-12 |