| NPI | 1902375090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE GRANRUTH Owner 410-534-8735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| 1041C0700X Social Worker Clinical | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2018-11-19 |