| NPI | 1912591637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH AGUS Executive Director 443-683-3498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2021-02-23 |