| NPI | 1922623313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMEELA MITCHELL Nurse Practitioner 443-300-6757 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) |
| 208D00000X General Practice | |
| 363LA2200X Nurse Practitioner Adult Health | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |