| NPI | 1922966746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DICKSON Owner Of Entity 240-203-7448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2026-01-12 |
| Last Update Date | 2026-01-12 |