| NPI | 1942447800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY L TAYLOR-ENNIS Psychologist 443-444-5798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MD 03567) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC2346) |
| 101YP2500X Counselor, Professional (Licence: MD LC2912) | |
| 101YP2500X Counselor, Professional (Licence: MD LC2940) | |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2009-01-14 |