| NPI | 1942724729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE LOWRY Regional Manager 410-259-8193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2018-10-15 |