| NPI | 1922987858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM WATSON Operations COO Rdinator 410-543-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2025-08-27 |
| Last Update Date | 2025-09-02 |