| NPI | 1942663398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GOLDBERG Therapist 443-835-6991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MD LGM568) |
| Enumeration Date | 2016-04-02 |
| Last Update Date | 2016-04-02 |