| NPI | 1912628256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRYSTAL WALLS Owner 240-362-7279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2022-09-06 |