| NPI | 1922990589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA JACKSON Owner 301-213-6399 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2025-07-17 |
| Last Update Date | 2025-07-17 |