| NPI | 1932658671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID DEFOE Owner 301-821-0049 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC6147) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC6147) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-10-15 |