| NPI | 1902651037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUWAYNE SMITH Owner 443-204-5641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 1041C0700X Social Worker Clinical | |
| Enumeration Date | 2024-04-22 |
| Last Update Date | 2024-04-22 |