| NPI | 1922753391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRA OWENS Owner 410-804-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics | |
| Enumeration Date | 2022-02-15 |
| Last Update Date | 2022-05-04 |