| NPI | 1881100857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JOHNSON Owner 410-274-8688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 364SP0807X Clinical Nurse Specialist Psychiatric/Mental Health, Child & Adolescent |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |