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 |